急性脑血管病患者甲状腺激素检测的临床意义

目的:探讨急性脑血管病患者甲状腺激素的变化及其临床意义.方法:将126例急性脑血管病患者分为脑出血组和脑梗死组,采用放射免疫分析动态观察其甲状腺激素水平,同时检测80例同龄健康体检者血清甲状腺水平.结果:①与对照组比较,脑出血组和脑梗死组血清T3和FT3降低(P＜0.01)血清rT3、T4 、FT4增高(P＜0.01),血清TSH无差别(P＞0.05);与脑梗死组比较,脑出血组血清T3和FT3降低(P＜0.05).②与轻型组和中型组比较,重型组血清T3和FT3降低(P＜0.01),血清rT3、T4 、FT4增高(P＜0.01),TSH在各组间无显著差异(P＞0.05).结论: 急性脑血管病患者急性期的保护性应激反应可引起T3和FT3下降,rT3升高,其中T3和FT3的降低与病情严重程度及预后密切相关.

Clinical Significance of Determination of Changes of Serum Thyroid Hormone Levels in Patients with Acute Cerebrovascular Diseases

Objective To investigate the clinical significance of alteration of serum thyroid hormone levels in patients with acute cerebrovascular diseases (ACVD). Methods Serum thyroid hormones (T3, FT3, rT3, T4, FT4, TSH) levels were determined with RIA in 126 patients with ACVD (cerebral hemorrhage or cerebral infarction) and 80 controls. Results In patients with ACDV, serum T3 and FT3 levels were significantly decreased (P<0.01), while serum rT3, T4 and FT4 were elevated (P<0.01) than those in controls, however, there were no significant changes in serum TSH levels (P>0.05). Serum T3 and FT3 levels were significantly lower in patients with cerebral hemorrhage than those in patients with cerebral infarction (P<0.01), but serum TSH levels were about the same in these two groups of patients (P>0.05). In patients with severe ACVD, the serum T3 and FT3 levels were significantly lower than those in patients with mild and moderate degree of ACVD (P<0.05). Conclusion Decreased serum T3 and FT3 and elevated rT3 levels are present in acute period in patients with ACVD. Serum T3 and FT3 levels might be used as an indicator of disease severity and outcome prediction in patients with ACVD.