缺血性脑卒中后血清甲状腺相关激素水平与预后的相关性

目的 分析缺血性脑卒中后甲状腺相关激素水平与预后的关系.方法 根据实验入选标准,选择2011年5月至2011年12月入住神经内科住院治疗的目标病例,入院第2天早晨获取血液标本,检测促甲状腺激素(thyroid stimulatinghormone,TSH)、总三碘甲状腺原氨酸(total triiodothyronine,TT3)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、总甲状腺素(total thyroxine,TT4)、游离甲状腺素(rree thyroxine,FT4)水平,并采用病后7d的日常生活活动能力量表(Barthel index,BI)评估早期功能预后情况,改良rankin量表(modified rankin scale,mRS)评估病后90 d的中期功能预后情况.根据病后7d和90 d的预后情况分组,分别比较各检测指标在各组间有无差异.利用Logistic回归模型综合分析年龄、性别、高血压病史、房颤史、糖尿病病史、脑卒中史、TSH、FT3、FT4水平与早、中期预后的关系.结果 入组86例,男44例,女42例,年龄(70.0±11.6)岁,发病至入院时间3.5～24h,平均12h,入院时美国国立卫生研究院卒中量表(NIHSS)评分3～8分,平均5分.单因素分析显示,FT3、FT4、TT3、TT4水平在病后7、90 d预后分组对比中差异均有统计学意义(P＜0.05).Logistic回归分析显示,甲状腺相关激素与缺血性脑卒中患者病后7d预后无明显相关,仅FT3水平与90d预后有统计学意义(P＜0.05).结论 FT3、FT4、TT3、TT4水平是缺血性脑卒中早、中期功能预后的影响因素,综合分析年龄、性别、既往史等危险因素后,仅FT3是缺血性脑卒中功能预后预测因素.TSH与缺血性脑卒中预后不相关.

Relationship between serum thyroid related hormone and outcome after ischemic stroke

Objective To explore the possible relationship between thyroid related hormone and outcomes following stroke. Methods The patients were chosen by the inclusion standards in neurology department of our hospital from May 2011 to December 2011.Blood sample was collected and detected the TSH, FT3, TT3, FT4, TT4 values in the next morning of admission. The Barthel index （BI）was used to assess the clinical outcome on 7 d after stroke. The modified Rankin scale （mRS） was uesd to assess the stroke outcome on 90 d. These influence factors were compared among groups. The Logistic regression model was adopted to analyze the correlation between the stroke outcome with these factors including age, sex, hypertension history, storke histo- ry, diabetes, atrial fibrillation, TSH, FY3, FT4 values. Results 86 patients with acute ischemic stroke were included.The baseline characteristics were as follows ： mean age 71.0 years, 44 males and 42 females, the time of onset to admission 12 （3.5-24） h ; the NIHSS scores 5 （3-8）. The univariate analysis results showed that the FF3, Tl＇3, FT4 and Tr4 values were different in each com- paring groups. The Logistic regression analyses showed that thyroid related hormones were not significantly associated with ischim- ic stroke outcome on poststoke 7 d.FT3 was only related to the 90 d stroke outcome. Conclusion The FT3 ,TT3, FF4 and TT4 levels are the influencing factors of stroke outcome in early and middle tenn. However,just the FT3 value is the predictive factors of function prognosis in stroke. The THS value has no relation to stroke outcome.