甲状腺素对急性脑梗死患者病情严重程度及预后的影响

目的探讨急性脑梗死患者血清甲状腺素水平与急性脑梗死的临床严重程度及预后的关系。方法收集无甲状腺疾病史的首次发生急性脑梗死患者的病例资料，按血清甲状腺素水平（T_3、T_4、TSH）和临床特点、血液检验指标进行分类及分析，并应用美国国立卫生研究院卒中量表（NIHSS）和改良Rankin量表（mRS）对神经功能缺损程度进行评估。结果低]T_3组患者血清T_3值（0．65±0．17）nmol／L]低于正常T_3组血清T_3值（1．34±0．28）nmol／L]（P〈0．01）；T_4、TSH值两组比较差异不明显（P〉0．05）。低T3组临床神经功能缺损程度评分明显高于正常T_3组（P〈0．01），血清T_3水平与人院时临床神经功能缺损程度评分呈负相关。低]T_3组临床神经功能改善程度明显低于正常T_3组（P〈0．05）。结论血清低T_3水平与急性脑梗死的临床严重程度及临床神经功能改善程度具有相关性，严重低T_3水平可能是急性脑梗死患者神经功能预后较差的一个预测因素。

The relationship between thyroid hormone Ievels and the state of severity in patients with acute cerebral infarction

To investigate associations of Thyroid Hormone status with clinical severity and outcome in acute ischemic stroke. Methods Patients with no history of thyroid abnormality who presented first stroke were studied. Total T_3, T_4, TSH levels, basic and clinical characteristics were collected and catego rized. Neurological impairment was assessed using National Institutes of Health Stroke Scale（NIHSS） and modified Rankin Scale（mRS）. Results The levels of serum T_3 （0. 65 ±0. 17）nmol/L] in low T3 group were significantly lower than those（1.34± 0. 28）nmol/L ] in normal T3 group（P〈0. 01）. Low T3 group had significant higher NIHSS compared to normal T3 group（P〈0. 01 ）, There was a significant negative correlation between T_3 levels and NIHSS scores on admission. A significantly smaller percentage of patients with low T_3 showed favorable neurological function improvement by both NIHSS and mRS measures compared to those with normal T3 （P〈0. 05）. Conclusions Low T_3 is associated with worse neurological outcome. The severity of low T_3 may be a predictor of functional improvement in acute ischemic stroke.