Xu Xiao-Yan, Li Wen-Yu, Hu Xing-Yue
Department of Neurology, The Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China.
Int J Endocrinol. 2016;2016:3470490. doi: 10.1155/2016/3470490. Epub 2016 Jun 8.
This study evaluated the prognostic value of thyroid-related hormones within normal ranges after acute ischemic stroke. This was a retrospective study and we reviewed 1072 ischemic stroke patients consecutively admitted within 72 h after symptom onset. Total triiodothyronine (T3), total thyroxine (T4), free T3, free T4, and thyroid-stimulating hormone (TSH) were assessed to determine their values for predicting functional outcome at the first follow-up clinic visits, which usually occurred 2 to 4 weeks after discharge from the hospital. 722 patients were finally included. On univariate analysis, poor functional outcome was associated with presence of atrial fibrillation as the index event. Furthermore, score of National Institutes of Health Stroke Scale (NIHSS), total T4, free T4, and C-reactive protein at admission were significantly higher in patients with poor functional outcome, whereas free T3 and total T3 were significantly lower. On multiple logistic regression analysis, lower total T3 concentrations remained independently associated with poor functional outcome [odds ratio (OR), 0.10; 95% confidence interval (CI), 0.01-0.84; P = 0.035]. The only other variables independently associated with poor functional outcome were NIHSS scores. In sum, lower total T3 concentrations that were within the normal ranges were independently associated with poor short-term outcomes.
本研究评估了急性缺血性卒中后甲状腺相关激素在正常范围内的预后价值。这是一项回顾性研究,我们回顾了症状发作后72小时内连续收治的1072例缺血性卒中患者。评估总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、游离T3、游离T4和促甲状腺激素(TSH)的值,以确定它们在首次随访门诊时预测功能结局的价值,首次随访门诊通常在出院后2至4周进行。最终纳入722例患者。单因素分析显示,以房颤为指标事件,功能结局差与之相关。此外,功能结局差的患者入院时美国国立卫生研究院卒中量表(NIHSS)评分、总T4、游离T4和C反应蛋白显著更高,而游离T3和总T3显著更低。多因素logistic回归分析显示,较低的总T3浓度仍独立与功能结局差相关[比值比(OR),0.10;95%置信区间(CI),0.01 - 0.84;P = 0.035]。唯一与功能结局差独立相关的其他变量是NIHSS评分。总之,正常范围内较低的总T3浓度独立与短期预后差相关。