甲状腺功能在脑出血急性期变化特点的研究

目的探讨脑出血出血量、意识水平、出血部位及转归与甲状腺功能的相关性。方法选取幕上脑出血患者67例,检测脑出血患者发病24 h内的甲状腺激素水平,运用统计学方法分析出血量、意识水平对甲状腺功能的影响。按出血部位分为丘脑出血组与非丘脑出血组,比较两组不同部位脑出血甲状腺激素的差异。于发病14 d比较治疗前后随着血肿的吸收、GCS评分的增加,甲状腺功能的改变。结果 (1)脑出血患者出血量、意识水平与急性期T3呈负相关,差异有统计学意义(P<0.05);与T4、TSH差异无统计学意义(P>0.05);(2)丘脑出血组与非丘脑出血组相比T3、TSH水平更低(P>0.05);(3)随着血肿水肿的吸收,T3升高(P<0.05),T4、TSH改变不明显(P>0.05);意识障碍程度恢复越好,T3恢复越明显(P<0.05)。结论 (1)脑出血患者出血量、意识水平与T3密切相关。(2)丘脑出血与非丘脑出血相比,T3、TSH降低更明显。(3)随着血肿的吸收及意识的好转,T3也相应升高。

The studies about changes of thyroid function in the acute phase of intracerebral hemorrhage

Objective To investigate the relationship between the severity,bleeding site and prognosis of intracerebral hemorrhage patients and the levels of thyroid hormone.Methods We select 67 patients which is hospitalized because of supratentorial cerebral hemorrhage.Then we detected the thyroid hormone levels of these patients on onset of 24 hours to analyze the effect of bleeding volume and consciousness level on thyroid function using statistical method.We divided the patients into two groups which were thalamic hemorrhage group and non-thalamic hemorrhage group according to the bleeding site.Then compared the differences of the two groups in thyroid hormones.Onset of the fourteenth day,compared the changes in thyroid function belong with the absorption of hematoma,the recovery of the consciousness patients after treatment.Results (1)The bleeding volume and level of consciousness were closely related to acute period T3 in patients with cerebral hemorrhage(P<0.05),while the bleeding volume and level of consciousness had no significant difference with T4、TSH(P>0.05).(2) The thalamic hemorrhage group had lower levels of T3 and TSH than non-thalamic group(P<0.05).(3) Belonging with the absorption of hematoma and the recovery of the consciousness after treatment,T3 increased (p <0.05),T4 and TSH had no significant change (P> 0.05).Conclusion (1) The bleeding volume and level of consciousness of cerebral hemorrhage is closely related to the levels of T3 in acute phase while has nothing to do with T4,TSH.(2) The thalamic hemorrhage group had lower levels of T3 and TSH compared to non-thalamic hemorrhage group.(3) Belonging withe absorption of hematoma and the recovery of the consciousness in patients after treatment,T3 recoveried also.