血清甲状腺抗体水平对脑梗死分型以及血管狭窄分布预测的研究  

Study of serum thyroid antibody levels on the classification of cerebral infarction and the prediction of vascular narrowing distribution

作　　者：余爱勇 杨柳 赵迎春[1] 陈晟[2] 彭亮 娄晓丽[3] 孙建军[4] 赵玉武[5] YU Aiyong;YANG Liu;ZHAO Yingchun(Department of Neurology,the Songjiang Hospital Affiliated To Shanghai Jiaotong University School of Medicine,Shanghai 201699,China)

机构地区：[1]上海交通大学医学院附属松江医院(筹)神经内科,上海201699 [2]上海交通大学医学院附属瑞金医院神经内科,上海200025 [3]上海交通大学医学院附属松江医院(筹)检验科,上海201699 [4]上海市公共卫生临床中心感染与免疫科,上海201052 [5]上海交通大学附属第六人民医院神经内科,上海200233

出　　处：《中风与神经疾病杂志》2021年第3期223-227,共5页Journal of Apoplexy and Nervous Diseases

基　　金：松江区科学技术攻关项目(No.15SJGG30)。

摘　　要：目的揭示甲状腺抗体的升高与脑梗死分型、血管狭窄分布的关系。方法在脑梗死患者中,选择甲状腺抗体完全正常的患者共99例,甲状腺抗体升高组的患者共计357例。比较两组患者发生脑梗死分型的不同特征、血管狭窄分布的不同特点。结果在心源性栓塞,甲状腺抗体升高组为17.17%(17/99),甲状腺抗体正常组为10.92%(39/357),差异有统计学意义,χ^(2)=4.352,P=0.037。小动脉闭塞,甲状腺抗体升高组为37.37%(37/99),甲状腺抗体正常组为26.89%(96/357),差异有统计学意义,χ^(2)=4.123,P=0.042。狭窄或闭塞的颅外动脉,甲状腺抗体升高组为1.01%(6/594),甲状腺抗体正常组为1.45%(319/2142),差异有统计学意义,χ^(2)=85.621,P=0.000。椎动脉颅内段,甲状腺抗体升高组为3.03%(6/198),甲状腺抗体正常组为0.70%(5/714),差异有统计学意义,χ^(2)=5.011,P=0.025。校正所有变量后发现,甲状腺抗体升高是心源性栓塞(OR=2.781,95%CI=1.198~6.293,P=0.034)、小动脉闭塞(OR=0.492,95%CI=0.392~0.820,P=0.013)的独立预测因子。结论甲状腺抗体升高的脑梗死患者出现心源性栓塞、小动脉闭塞的比例高,颅外动脉狭窄或闭塞的比例低,椎动脉颅内段狭窄或闭塞的比例高。Objective In order to reveal the relationship between the increase of thyroid antibodies and the type of cerebral infarction and the distribution of vascular stenosis.Methods Among patients with cerebral infarction,99 patients with completely normal thyroid antibodies were selected,and 357 patients with elevated thyroid antibodies were selected.Different features of cerebral infarction classification and vascular stenosis distribution were compared between the two groups of patients.Results In terms of cardiogenic embolism,17.17%(17/99)of the elevated thyroid antibody group and 10.92%(39/357)of the normal thyroid antibody group,the difference was statistically significant,P=0.037.In terms of small arterial occlusion,the thyroid antibody increase group was 37.37%(37/99)and the normal thyroid antibody group was 26.89%(96/357).In terms of narrowed or occluded extracranial arteries,the thyroid antibody elevation group was 1.01%(6/594),and the normal thyroid antibody group was 1.45%(319/2142).The difference was statistically significant,P=0.000.Regarding the intracranial segment of the vertebral artery,3.03%(6/198)of the thyroid antibody increased group and 0.70%(5/714)of the normal thyroid antibody group,the difference was statistically significant,P=0.025.After adjusting for all variables,it was found that thyroid antibody elevation was cardiogenic embolism(OR=2.781,95%CI=1.198~6.293,P=0.034),arterial occlusion(OR=0.492,95%CI=0.392~0.820,P=0.013).Conclusions Patients with cerebral infarction with elevated thyroid antibodies have a higher proportion of cardiogenic embolism and arterial occlusion,a lower proportion of extracranial artery stenosis or occlusion,and a higher proportion of vertebral artery intracranial stenosis or occlusion.

关 键 词：甲状腺抗体 脑梗死 颅内动脉狭窄 

分 类 号：R743[医药卫生—神经病学与精神病学]