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急性缺血性卒中患者静脉溶栓后,低游离三碘甲状腺原氨酸水平与症状性颅内出血及不良功能预后相关。

Low free triiodothyronine levels are related to symptomatic intracranial hemorrhage and poor functional outcomes after intravenous thrombolysis in acute ischemic stroke patients.

作者信息

Liu Junfeng, Wang Deren, Xiong Yao, Yuan Ruozhen, Tao Wendan, Liu Ming

机构信息

a Stroke Clinical Research Unit, Department of Neurology , West China Hospital, Sichuan University , Chengdu , P.R. China.

出版信息

Neurol Res. 2016 May;38(5):429-33. doi: 10.1080/01616412.2016.1178480. Epub 2016 Apr 28.

Abstract

BACKGROUND AND OBJECTIVE

Low free triiodothyronine (fT3) levels have been associated with increased mortality and poor functional outcomes in patients with stroke. However, the research of relationship between fT3 levels and acute ischemic stroke (AIS) patients with intravenous thrombolysis (IVT) is scarce. We aimed to investigate the association of fT3 levels with symptomatic intracranial hemorrhage (sICH) and functional outcomes at discharge in AIS patients with IVT.

METHODS

Patients with AIS admitted to West China hospital, Sichuan University, who had underwent IVT treatment, were consecutively and retrospectively included. Demographic and clinical information were collected and analyzed according to the levels of fT3. We used logistic regression analysis to estimate the multivariable adjusted association of fT3 levels and post-IVT sICH, and functional outcomes at discharge.

RESULTS

Among the 46 patients (26 males; mean age, 63.6 years) in the final analysis, 17 patients (37.0%) had fT3 levels lower than the reference range. After adjustment for age, gender, and statistically important variables (NIHSS on admission, urea levels and creatinine levels), low fT3 levels were significantly associated with post-IVT sICH (p = 0.01, OR = 0.27, 95% CI 0.10-0.77) and poor functional outcomes at discharge (p = 0.04 OR = 2.58, 95% CI 1.05-6.35).

CONCLUSION

We found that lower free T3 levels are independently related to post-IVT sICH and poor functional outcomes at discharge in AIS patients with IVT, which should be verified and extended in large cohorts in the future.

摘要

背景与目的

低游离三碘甲状腺原氨酸(fT3)水平与卒中患者死亡率增加及功能预后不良相关。然而,关于fT3水平与接受静脉溶栓(IVT)的急性缺血性卒中(AIS)患者之间关系的研究较少。我们旨在探讨AIS接受IVT治疗患者的fT3水平与症状性颅内出血(sICH)及出院时功能预后的相关性。

方法

连续纳入并回顾性分析四川大学华西医院收治并接受IVT治疗的AIS患者。根据fT3水平收集并分析人口统计学和临床信息。我们采用逻辑回归分析来评估fT3水平与IVT后sICH及出院时功能预后的多变量校正相关性。

结果

最终分析的46例患者(26例男性;平均年龄63.6岁)中,17例(37.0%)fT3水平低于参考范围。在调整年龄、性别及统计学重要变量(入院时美国国立卫生研究院卒中量表评分、尿素水平和肌酐水平)后,低fT3水平与IVT后sICH显著相关(p = 0.01,OR = 0.27,95%CI 0.10 - 0.77)及出院时功能预后不良相关(p = 0.04,OR = 2.58,95%CI 1.05 - 6.35)。

结论

我们发现较低的游离T3水平与接受IVT的AIS患者IVT后sICH及出院时功能预后不良独立相关,未来应在大型队列中进行验证和拓展。

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