急性脑梗死患者甲状腺激素变化及临床意义  

The clinical value and significance of thyroid hormone changes in patients with acute cerebral infarction

作　　者：李军[1] 戴艳萍[1] 张春媛[1] 陈晓光[1] 齐丹[1] 曹利[1] Li Jun Dai Yanping Zhang Chunyuan Chen Xiaogtmng Qi Dan Cao Li(The First Department of Neurology of Heilongjiang Provincial Hospital, Harbin 150001, China （Li J, Dai YP, Zhang CY, Chen XG, Qi D, Cao L)

机构地区：[1]黑龙江省医院南岗院区神经内一科,哈尔滨150001

出　　处：《中华地方病学杂志》2017年第3期223-225,共3页Chinese Journal of Endemiology

摘　　要：目的观察急性脑梗死患者急性期和恢复期甲状腺激素水平变化，并探讨其临床价值。方法选择2015年3月至2016年5月在黑龙江省医院住院治疗的急性脑梗死患者50例作为观察组，以同时期进行健康体检的30人作为对照组。采集观察组第2天（急性期）和第14天（恢复期）患者和同时期对照组人群的晨起空腹静脉血，采用化学发光法检测血清三碘甲腺原氨酸（B）、甲状腺素（T4）、游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）。按照恢复期FT3水平，将脑梗死患者分为低FT3组（n〈3．10pmol／L）与正常FT3组（FT3≥3．10pmol／L）．分别在患者出院时和出院后90d，应用美国国立卫生研究院卒中量表（NIHSS）评定脑梗死患者的神经功能缺损情况。根据NIHSS评分改善情况判断患者预后，MHSS评分改善≥2分为预后良好。结果急性期脑梗死患者T3、FT3水平与对照组比较明显降低[（0．68±0．22）比（1．82±0．31）nmol／L，（2．08±0.31）比（4．19±0．75）pmol／L，P均〈0．05]；而T4、FT4和TSH与对照组比较明显升高，差异有统计学意义[（142．56±20．78）比（109．89±12．37）nmol／L，（12．88±1．15）比（9．77±0．96）pmol／L，（5．15±1．16）比（2．95±1．31）mU／L，P均〈0．05]。与急性期比较，恢复期脑梗死患者血清T3、FT3水平[（1．75±0．19）nmol／L，（3．97±0．61）pmol／L]明显升高，差异有统计学意义（P均〈0．05），而T4、FT4和TSH[（115．64±14．38）nmol／L，（10．05±1．02）pmol／L，（3．16±0．98）mU／L]明显降低，差异有统计学意义（P均〈0．05）。与对照组比较，恢复期脑梗死患者血清T3、T4、FT3、FT4和TSH差异均无统计学意义（P均〉0．05）。患者出院时NIHSS评分与恢复期血清凡水平呈负相关关系（r=-0．586，P〈0．05）。出院90d后，低FT3组NIHSS评分改善�Objective To observe the thyroid hormone （TH） changes in patients with acute cerebral infarction in acute phase and convalescence, and to explore its clinical value. Methods Fifty cases of acute cerebral infarction patients from March 2015 to May 2016 in Heilongjiang Provincial Hospital were selected as observation group, at the same time 30 cases of healthy check-up people as control group. Serum levels of triiodothyronine （T3）, thyroxine fin）, free triiodothyronine （FT3）, free thyroxine （FT4） and thyroid stimulating hormone （TSH） were measured in 50 cases of acute cerebral infarction patients on the 2nd day （acute phase） and the 14th day （recovery） after onset of the disease, by using chemiluminescence method, and 30 cases of people underwent healthy physical check-up were treated the same way. Neurological injury and recovery of patients with cerebral infarction were evaluated using NIHSS. According to the recovery level of FT3, patients with cerebral infarction were divided into low FT3 group （FT3 〈 3.10 pmol/L） and normal FT3 group （FT3 ≥ 3.10 pmol/L）. Prognosis of the patients was judged according to the NIHSS scores 90 days after discharged from the hospital, and NIHSS score improving acuity of 2 was judged as good prognosis. Results The T3 and FT3 levels in patients with acute cerebral infarction were significantly lower than those of people underwent healthy physical examination, the differences were statistically significant [（0.68 ± 0.22） vs（1.82 ± 0.31） nmol/L, （2.08 ± 0.31） vs （4.19 ± 0.75） pmol/L, all P 〈 0.05]. The T4, FT4 and TSH levels in patients with acute cerebral infarction were increased significantly, the differences were statistically significant [（142.56 ± 20.78） vs （109.89 ± 12.37） nmol/L, （12.88±1.15） vs （9.77 ± 0.96） pmol/L, （5.15±1.16） vs （2.95 ± 1.31） mU/L, all P 〈 0.05]. Compared with the acute phase, convalescence of cerebral infarction patients＇ serum T3 and FT3 levels [（1.75± 0.19

关 键 词：脑梗塞 甲状腺激素类 数据收集 

分 类 号：R743.3[医药卫生—神经病学与精神病学]