Department of Neurology and Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea.
Endocr J. 2010;57(8):711-8. doi: 10.1507/endocrj.k10e-135. Epub 2010 Jul 15.
Thyroid dysfunction has been known to be closely associated with increased vascular events. The aims of the present study included determining the prevalence of subclinical thyroid disease and relationships between normal ranges of thyroid function and internal carotid artery steno-occlusion (ICS) in patients with ischemic stroke. From March 2007 to February 2008, 382 consecutive patients with ischemic stroke referred to the neurovascular ultrasound laboratory were analyzed. ICS was defined as greater than 50% luminal narrowing or complete obstruction in at least 1 internal carotid artery. Subclinical thyroid disease was determined by free thyroxine (fT4) and thyroid stimulating hormone (TSH) measurements. After the exclusion of patients with abnormal levels of thyroid hormones, normal ranges of fT4 were classified into 3 groups: low-normal (fT4, 11.012.3 pmol/L), mid-normal (12.415.4), and high-normal (15.5~24.0) thyroid groups. There were 17 patients (4.5%) with subclinical hypothyroidism and 6 (1.6%) with subclinical hyperthyroidism. There were 301 patients (78.8%) with normal fT4 and TSH levels, and among them, 67 patients (22.3%) had ICS. There was a significantly higher percentage of ICS in the low-normal thyroid group than in the other groups. By multivariate regression analysis, the low-normal fT4 group had an OR of 2.80 (95% confidence interval, 1.39-5.66) for ICS compared to the mid-normal group. In patients with ischemic stroke, the prevalence of subclinical thyroid disease was similar to the general population, and in euthyroid patients, low-normal thyroid function was independently associated with a higher percentage of ICS.
甲状腺功能障碍与血管事件的增加密切相关。本研究的目的包括确定亚临床甲状腺疾病的患病率以及甲状腺功能正常范围内的甲状腺功能与缺血性卒中患者颈内动脉狭窄闭塞（ICS）之间的关系。2007 年 3 月至 2008 年 2 月，分析了 382 例连续缺血性卒中患者的神经血管超声检查结果。ICS 定义为至少 1 条颈内动脉管腔狭窄>50%或完全闭塞。亚临床甲状腺疾病通过游离甲状腺素（fT4）和促甲状腺激素（TSH）测量确定。排除甲状腺激素水平异常的患者后，将正常 fT4 范围分为 3 组：低正常（fT4，11.012.3pmol/L）、中正常（12.415.4）和高正常（15.5~24.0）甲状腺组。亚临床甲状腺功能减退患者 17 例（4.5%），亚临床甲状腺功能亢进患者 6 例（1.6%）。301 例（78.8%）患者 fT4 和 TSH 水平正常，其中 67 例（22.3%）存在 ICS。低正常甲状腺组 ICS 发生率明显高于其他组。多变量回归分析显示，与中正常组相比，低正常 fT4 组 ICS 的 OR 值为 2.80（95%可信区间，1.39-5.66）。在缺血性卒中患者中，亚临床甲状腺疾病的患病率与一般人群相似，在甲状腺功能正常的患者中，低正常甲状腺功能与 ICS 发生率的升高独立相关。
