动脉硬化性脑梗死患者血清FT3、FT4、RC水平及其与短期预后的相关性  

Correlation analysis of serum FT3,FT4,RC levels and short⁃term prognosis in patients with atherosclerotic cerebral infarction

作　　者：陈雷[1] 刘时华[1] 梁彩霞[1] 张如梦 陈岩 CHEN Lei;LIU Shihua;LIANG Caixia;ZHANG Rumeng;CHEN Yan(Department of Neurology,Anhui Medical University Affiliated Suzhou Hospital,Suzhou,Anhui,China,234000)

机构地区：[1]安徽医科大学附属宿州医院神经内科,安徽宿州234000

出　　处：《分子诊断与治疗杂志》2024年第8期1420-1424,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省高校自然科学基金项目(KJ2020A0193)。

摘　　要：目的分析血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、残余胆固醇(RC)在动脉硬化性脑梗死(ACI)患者中的水平,并探讨三者与ACI患者短期预后的关系。方法收集2021年1月至2023年10月于安徽医科大学附属宿州医院接受静脉溶栓治疗的ACI患者180例为ACI组,采用改良Rankin量表(mRS)评分对发病后90 d患者预后进行评估。将ACI组分为预后良好组和预后不良组两个亚组。同时纳入健康体检者180名作为对照组。采用放射免疫分析法检测两组血清FT3、FT4、RC水平;采用多因素Logistic回归分析影响因素;采用ROC曲线评价诊断价值。结果ACI组患者血清RC水平明显高于对照组,而血清FT3、FT4水平明显低于对照组,差异有统计学意义(P<0.05);预后不良组中高血压、糖尿病、中重度动脉狭窄比例及NIHSS评分、hs⁃CRP、D⁃D、梗死灶最大直径、LDL⁃C、RC水平均明显高于预后良好组,血清FT3、FT4水平明显低于预后良好组,差异有统计学意义(P<0.05);高NIHSS评分、高hs⁃CRP、高D⁃D、低FT3、低FT4水平、高RC水平、高梗死灶最大直径及中、重度动脉狭窄是ACI患者预后不良的独立危险因素(P<0.05);血清FT3、FT4、RC及三者联合诊断ACI患者预后不良的曲线下面积(AUC)分别为0.869、0.832、0.840、0.951,三者联合的AUC明显高于三者单独诊断(P<0.05)。结论血清FT3、FT4、RC水平异常与ACI的发生和发展密切相关,三者联合检测对ACI患者是否发生预后不良有较高的诊断价值。Objective To analyze and compare the levels of serum free triiodothyronine(FT3),Free thyroxine(FT4)and remnant cholesterol(RC)in patients with atherosclerotic cerebral infarction(ACI),and to explore the relationships all of them and the short⁃term prognosis of ACI.Methods A total of 180 ACI patients who received intravenous thrombolytic therapy at Suzhou Hospital Affiliated to Anhui Medical University from January 2021 to October 2023 were enrolled in the ACI group.Additionally,180 healthy subjects were included as the control group.General data of the subjects were collected and compared.Radioimmunoassay was used to detect serum levels of FT3,FT4,and RC in both groups.Multiple logistic regression analysis was conducted to identify influencing factors.The ROC curve was used to evaluate diagnostic value.Results The level of RC in the ACI group was significantly higher than that in the control group,and the levels of FT3 and FT4 in the ACI group were significantly lower than those in the control group(P<0.05).Hypertension,diabetes,the proportion of moderate and severe arterial stenosis,NIHSS score,hs⁃CRP,D⁃D,maximum diameter of infarct,LDL⁃C,and RC levels in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).Serum FT3 and FT4 levels were also significantly lower in the poor prognosis group.High NIHSS score,high hs⁃CRP,high D⁃D,low FT3,low FT4,high RC,high maximum diameter of infarct,and moderate and severe arterial stenosis were identified as independent risk factors for poor prognosis in ACI patients(P<0.05).The area under curve(AUC)of serum FT3,FT4,RC and their combined diagnosis of poor prognosis in ACI patients were 0.869,0.832,0.840 and 0.951,respectively.The AUC of their combined diagnosis was significantly higher than that of their single diagnosis(P<0.05).Conclusion The abnormal levels of serum FT3、FT4 and RC are closely related to the occurrence and development of ACI.The combined detection of these levels has a high diagnostic value for predicti

关 键 词：动脉硬化性脑梗死 游离三碘甲状腺原氨酸 残余胆固醇 

分 类 号：R743.33[医药卫生—神经病学与精神病学]