高血压脑出血甲状腺功能异常患者再出血及预后的观察

目的 探讨高血压脑出血(HICH)甲状腺功能异常患者再出血的发生与预后情况.方法 纳入盐城市亭湖区人民医院2014年5月至2019年5月收治的HICH甲状腺功能异常患者80例.根据患者是否发生再出血,分成再出血组14例、未再出血组66例.比较两组甲状腺功能指标,包括促甲状腺激素(TSH)、总甲状腺素(TT4)、总三碘甲...

Rebleeding and prognosis of patients with hypertensive cerebral hemorrhage combined with abnormal thyroid function

Objective To investigate the incidence of rebleeding and prognosis in patients with hypertensive cerebral hemorrhage(HICH)combined with abnormal thyroid function.Methods 80 patients with HICH combined with abnormal thyroid function admitted to people’s hospital of Tinghu district,Yancheng city,from May 2014 to May 2019 were included.According to whether rebleeding occurred,patients were divided into rebleeding group(n=14)and no rebleeding group(n=66).Thyroid function indexes of the two groups were compared,including thyroid stimulating hormone(TSH),total thyroxine(TT4),total triiodothyronine(TT3),free thyroxine(FT4)and free triiodothyronine(FT3).The volume of hematoma after rebleeding was recorded,and the correlation between the thyroid function index and the volume of hematoma was analyzed.The prognosis of patients were observed,and the thyroid function indexes of survival group and death group were compared,the working characteristic curve(ROC)was used to analyze the predictive value of related serum indexes to the prognosis of patients.Results Among 80 patients,14(17.50%)had rebleeding and 66(82.50%)didn’t develop rebleeding.Serum TT3,FT3 were significantly lower in the rebleeding group than those in the non rebleeding group,and TSH was significantly higher than that in the non rebleeding group(t=2.249,6.713,3.099,P<0.05).In 14 patients with rebleeding,the average hematoma volume was(41.39±7.53)mL.According to Pearson linear correlation,hematoma volume was negatively correlated with serum TT3 and FT3(r=-0.487,-0.589,P<0.05),and positively correlated with serum TSH(r=0.495,P<0.05).Of the 80 patients,10(12.50%)died and 70(87.50%)survived.The levels of TT3 and FT3 in the death group were significantly lower than those in the living group,and the levels of TSH in the death group was significantly higher than that in the living group(t=2.185,2.969,3.463,P<0.05).The area under the curve of serum TSH,TT3 and FT3 predicting the prognosis of patients was 0.916,0.605,0.937 respectively,P values were<0.05,>0.05 and<0.05 respectively.Conclusion The down-regulation of serum TT3 and FT3,and the up-regulation of serum TSH may be related with the occurrence of rebleeding in patients HICH combined with abnormal thyroid function,and serum TSH and FT3 have a certain predictive value for the prognosis.