血清甲状腺激素对脑卒中事件的影响

Influence of serum thyroid hormone on acute stroke event

摘要:

目的通过分析急性脑卒中患者甲状腺激素水平的变化，探讨甲状腺激素与脑卒中事件的关系。方法选取2015年6月-2016年6月发病7 d内的急诊脑卒中患者164 例为急性脑卒中组，健康查体者180例为健康对照组。检测血三碘甲状腺原氨酸（T3）、甲状腺素（T4）、FT3 （游离T3）、FT4（游离T4）、促甲状腺素（TSH）、血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、血糖、纤维蛋白原（FIB）及同型半胱氨酸的浓度。比较两组甲状腺激素水平的变化，分析甲状腺激素与脑卒中事件的关系。结果①急性脑卒中组FT4较健康对照组比较降低[（15.41±2.83）vs（16.78±3.74）， =0.027]，FT3、T3、T4及TSH 与健康对照组比较差异无统计学意义（p >0.05）。②急性脑卒中组FIB、血糖、TC、LDL、载脂蛋白B及同型半胱氨酸（Hcy）较健康对照组升高（p <0.05）；HDL、载脂蛋白A 及三酰甘油在两组比较差异无统计学意义（p >0.05）。③Logistics回归分析提示FT4增高使脑卒中风险减低81.9%（1/OR），高血糖和高Hcy 分别使脑卒中风险增加2.94 和1.07 倍（1/OR）。结论血清FT4减低可增加脑卒中事件发生的风险。

Abstract:

Objective To study the relationship between thyroid hormone and acute stroke event by analysis of the variety of thyroid hormone in acute stoke patients. Methods A total of 164 acute stroke patients who were first-ever stroke and within 7 days after symptom onset from June 2015 to June 2016 were selected as observation group, and 180 healthy cases were selected as control group. General conditions and previous history were collected. T3, T4, FT3, FT4, TSH, TC, TG, LDL, HDL, blood sugar, FIB and homocysteine (Hcy) in the blood were tested. Results FT4 was lower in the observation group than in the control group [(15.41 ±2.83) vs (16.78 ±3.74),p < 0.05]; FT3, T3, T4 and TSH had no differences between the two groups (p > 0.05). Compared with the heathy control group, the FIB, blood glucose, TC, LDL, ApoB and Hcy were higher in the acute stroke group (p < 0.05), and there was no statistically significant difference in HDL, ApoA or TG between the two groups (p > 0.05). Logistic regression analysis showed that the increase of FT4 reduced the risk of stroke by 81.9%(1/OR), high blood glucose and high Hcy increased the risk of stroke by 2.94 and 1.07 times (1/OR) respectivly. Conclusions The study showed that lower FT4 in the blood may increase the risk of stroke.