甲状腺病态综合征预测缺血性脑卒中相关性肺炎风险  

作　　者：段婷婷 颜佳 杨铭 牛国忠[3] 吴冠会[2] 

机构地区：[1]浙江中医药大学附属衢州中心医院,324000 [2]南京医科大学附属苏州医院(苏州市立医院),211103 [3]杭州市第一医院,310006

出　　处：《浙江临床医学》2022年第10期1498-1500,1503,共4页Zhejiang Clinical Medical Journal

基　　金：江苏省卫生健康委员会高层次卫生人才“六个一工程”拔尖人才科研项目(LGY2019015);苏州市姑苏卫生人才项目(GSWS2019057)。

摘　　要：目的探讨甲状腺病态综合征预测缺血性脑卒中相关性肺炎风险的价值。方法选取发病72 h内的急性脑梗死患者作为研究对象,根据是否伴发缺血性脑卒中相关性肺炎按照年龄、性别匹配的方式选取感染组172例和对照组172例,比较两组患者入院时临床资料和甲状腺激素水平等血液学检查结果,采用Logistic回归分析影响患者发生脑卒中相关性肺炎的影响因素。结果感染组伴发心房颤动或ESS、高洼田饮水试验评分患者比例明显高于对照组(P均<0.001),感染组NIHSS评分明显高于对照组(P<0.001)。感染组患者T3、fT3、TSH水平明显低于对照组(P<0.05),fT4水平明显高于对照组(P<0.001)。两组患者T4水平无明显差异(P>0.05)。Logistic回归分析显示,伴发心房颤动(P=0.010)或ESS(P<0.001)、高洼田饮水实验评分(P<0.001)是脑卒中相关性肺炎的独立危险因素。结论入院时存在的甲状腺病态综合征可以预测缺血性脑卒中相关性肺炎的风险升高。Objective To evaluate the value of euthyroid sick syndrome in predicting the risk of ischemic stroke associated pneumonia.Methods Patients with acute cerebral infarction within 72 hours after onset were selected as the research subjects.According to whether they were associated with ischemic stroke associated pneumonia,172 patients in the infection group and 172 patients in the control group were selected after matching the age and gender.The patients'clinical data and hematological examination results such as thyroid hormone level in both groups at admission were collected and compared.Logistic regression was used to analyze the influencing factors of stroke associated pneumonia.Results The proportion of patients with atrial fibrillation or ESS and scores of water swallow test in the infection group were significantly higher than those in the control group(all P<0.001).The NIHSS scores in infection group were significantly higher than those in control group(P<0.001).T3,fT3 and TSH levels in infection group were significantly lower than those in control group(P<0.05).fT4 levels were significantly higher than those of control group(P<0.001).T4 levels were not significantly different between the two groups(P>0.05).Logistic regression analysis showed that atrial fibrillation(P=0.010)or ESS(P<0.001)and scores of water swallow test(P<0.001)were independent risk factors for ischemic stroke associated pneumonia.Conclusion Presence of euthyroid sick syndrome at admission predicts an increased risk of ischemic stroke associated pneumonia.

关 键 词：急性脑梗死 甲状腺病态综合征 脑卒中相关性肺炎 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R563.1[医药卫生—临床医学]