摘要
目的评估亚临床型甲状腺功能减退(SCH)对急性缺血性脑卒中发病时症状严重程度及出院时功能转归的影响。方法回顾性分析2011-01—2012-01苏州大学附属一院神经内科住院治疗的130例首发急性缺血性脑卒中患者的临床资料,所有患者入院后均行甲状腺功能测定,进而分为SCH组(52例)和甲状腺功能正常组(78例)。对比2组一般资料、血管危险因素、牛津郡临床分型,通过美国国立卒中量表(NIHSS)评分评定卒中严重程度。所有患者在卒中后第1、3月评定Barthel指数。结果 78例(60%)患者甲状腺功能正常,52例(40%)患者存在亚临床甲减。2组患者入院时NIHSS评分差异无统计学意义,合并亚临床甲减患者功能转归良好病例占比在发病1、3月时均高于正常甲状腺功能组。结论急性缺血性脑卒中患者亚临床甲状腺功能减退状态能改善出院时功能转归,这种相关性的原因可能与缺血预处理、肾上腺素水平降低及低代谢状态有关。
Objective To investigate the effects of subclinical hypothyroidism （SCH） on ischemic stroke severity and its functional outcome. Methods One-hundred thirty consecutive patients admitted for first-ever cerebral isehemic stroke who met the inclusion criteria of this study were included. Serum thyroid-stimulating hormone （TSH） levels were measured for all pa- tients. They were divided into SCH group （n= 52）and serum TSH group（n： 78）. Stroke severity was recorded for each patient on admission using the NIH Stroke Scale. The patients were followed, and their functional outcomes were evaluated at 1 and 3 months after stroke using the Barthel index. Results Of the patients, 78 （60%） had normal serum TSH, and 52 （40%） had SCH. Patients with higher levels of serum TSH and those with normal serum TSH have the same stroke severity on admission,but the patients with SCH have a significantly better outcome, as theBarthel index at 1 （P〈0.01） and 3 （P=0.05） months of follow-up. Conclusion This study showed a significant protective association of SCH with better outcomes after cerebral ischemic stroke. Possible explanations for this association are ischemic preconditioning, reduced adrenergic tone, and hypometabolic state.
出处
《中国实用神经疾病杂志》
2013年第19期3-5,共3页
Chinese Journal of Practical Nervous Diseases
