血清三碘甲状腺原氨酸减低与急性脑卒中  

The relationship between low triiodothyronine and acute stroke

作　　者：李辉[1] 杜晓莉[2] 杨颖慧 王文远[1] 王肖肖[1] 许蕾[1] 

机构地区：[1]河北医科大学第二医院神经内科河北省神经病学重点实验室,石家庄050000 [2]衡水市第四人民医院神经内科 [3]衡水市故城县医院神经内科

出　　处：《脑与神经疾病杂志》2016年第4期220-223,共4页Journal of Brain and Nervous Diseases

摘　　要：目的探讨在急性脑卒中患者中,血清三碘甲状腺原氨酸(T3)减低与卒中严重程度的关系。方法收集2015年5月至2015年10月在河北医科大学第二医院神经内科住院,首次发病,且发病在7d内的急性脑卒中患者(脑梗死或脑出血)82例为急性脑卒中组和同期住院的非脑卒中患者36例为对照组。采集两组研究对象的一般资料,抽空腹血测定T3,行NIHSS评分。比较T3在两组中的差异,并分析T3和年龄,发病天数及NIHSS评分之间的关系。结果本研究共纳入118例,急性脑卒中82例(其中脑梗死患者72例,脑出血10例),对照组36例(其中眩晕11例,帕金森病4例,多发性神经炎18例,癫痫3例)。1T3减低在急性脑卒中组的发生率明显高于对照组(24.2%vs 5.6%,P<0.05);2T3减低在中老年组的发生率明显高于青年组(P<0.05);3平均发病天数在T3减低组和T3正常组之间差异无统计学意义(53.3h vs 52.17h,P>0.05);4T3减低在中-重度脑卒中(NIHSS≥8分)组的发生率显著高于轻度脑卒中组(NIHSS<8分)(18.03%vs 42.86%,P<0.05);5T3减低组的平均NIHSS评分显著高于T3正常组(8.65 vs 4.48,P<0.05),且T3与NIHSS评分呈负的线性相关(B=-3.222,P<0.05)。结论 T3减低发生于脑卒中急性期,多见于老年和中-重度脑卒中患者。T3越低,则NIHSS评分越高,神经功能受损程度越重,推测预后可能越差。Objective The clinical study were attributed to analyze the relationship between low T3 and the extent of neurological impairment. Methods We collected the acute stroke patients, who visited neurology of the Second Hospital of Hebei Medical University from May 2015 to October 2015, were first-ever stroke and within 7 days after symptoms onset, and non-stoke patients, who were in hospital during the same period with acute stroke group. Collect general conditions, previous history and T3, NIHSS scores were used to evaluate the severity of stroke. Results There were 82 acute stroke（ including cerebral ischemic in 72 cases, intracerebral hemorrhage inlO cases） subjects in test group, and 36 non-stoke subjects in control group. （1）Compared with control group, the low T3 is more obvious in acute stroke group （ 24.2% vs 5.6%, P〈0.05）.（2）The low T3 was more prevalent in the old acute stroke patients （P〈0.05）. （3）The mean days of stroke onset was no value between low T3 group and normal T3 group （53.3h vs 52.17h, P〉0.05）. （4）The rates of low T3 is respectively 21.74% and 27.78% in mild stroke （NIHSS ≤ 8） and moderate-severe stroke （NIHSS〉8） （P〈0.05）. （5）The score of NIHSS was more higher in low T3 group than normal T3 group （8.65 vs 4.48, P〈0.05）, and T3 was negatively associated with NIHSS by linear correlation during all of the acute stroke subjects （ B = -3. 222, P = 0. 027,95 % CI = - 6. 074 - - 0. 371 ）. Conclusion Acute stroke patients appears to have low T3, which happens to the olds and the severe stroke patients, not related to days of stroke onset. And in acute stroke, the neurological impairment is more the severer by the lower does T3 reduce, the prognosis may be more poor.

关 键 词：急性脑卒中 血清三碘甲状腺原氨酸减低 NIHSS评分 

分 类 号：R743.32[医药卫生—神经病学与精神病学]