Abstract: Objective  To explore the correlation between thyroid hormone levels in patients with acute ischemic stroke and the severity of disease and short-term prognosis. Methods  According to the level of serum total triiodothyronine (TT₃), 98 patients who presented first acute ischemic stroke and without history of thyroid abnormality were divided into low TT₃ group and normal TT₃ group. Thyroid hormone levels and neurological function defect of those patients were tested, and their neural functional recovery after 3 months was evaluated.  Results  Low TT₃ group had more severe neural function defect compared to normal TT₃ group (χ² = 58.134, P = 0.000). There were no significant differences on total thyroxine (TT₄; t = 1.636, P = 0.105) and thyroid stimulating hormone (TSH; t = 1.059, P = 0.292) between 2 groups. There was a significantly negative correlation between TT₃ levels and National Insititute of Health Stroke Scale (NIHSS) score on admission (r = -0.672, P = 0.000). Patients with low TT₃ showed a significantly smaller percentage of neurological function improvement on both NIHSS ( χ² = 8.993, P = 0.003) and modified Rankin Scale (mRS; χ² = 6.247, P = 0.012) scores compared to those with normal TT₃ at 90 d after onset.  Conclusions  Low T₃ level is associated with the severity of acute ischemic stroke and neural functional recovery, suggesting serum T₃ level may be a predictor of neural function improvement in patients with acute ischemic stroke.

Key words: Brain ischemia, Thyroid hormones, Euthyroid sick syndromes

摘要： 目的 探讨急性缺血性卒中患者血清甲状腺激素水平变化与病情严重程度和短期预后的相关性。方法 根据血清总三碘甲状腺原氨酸（TT₃）水平将98 例既往无甲状腺疾病史的急性缺血性卒中患者分为低TT₃ 组和正常TT₃ 组，检测血清甲状腺激素水平和神经功能缺损程度，评价发病90 d 时神经功能恢复情况。结果 低TT₃ 组患者神经功能缺损程度比正常TT₃ 组严重（χ² = 58.134，P = 0.000），血清总甲状腺素（t = 1.636，P = 0.105）和促甲状腺激素（t = 1.059，P = 0.292）水平基本相同；血清TT₃ 水平与神经功能缺损程度［美国国立卫生研究院卒中量表（NIHSS）］呈负相关关系（r = -0.672，P = 0.000）；发病90 d 时低TT₃ 组患者神经功能改善程度［NIHSS 评分改善（χ² = 8.993，P = 0.003）和改良Rankin 量表评分（χ² = 6.247，P = 0.012）］低于正常TT₃ 组。结论 血清低T₃ 水平与急性缺血性卒中严重程度和神经功能改善程度存在关联性，提示血清低T₃水平可能是预测急性缺血性卒中神经功能预后的一项指标。

关键词: 脑缺血, 甲状腺激素类, 功能正常甲状腺病综合征