Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China..
Am J Geriatr Psychiatry. 2018 Dec;26(12):1222-1230. doi: 10.1016/j.jagp.2018.07.007. Epub 2018 Jul 29.
Low tri-iodothyronine (T3) syndrome is a predictor of poor prognosis in patients with stroke. Poststroke cognitive impairment (PSCI) is a common and important complication after stroke. The association between low T3 syndrome and PSCI is unclear. We aimed to explore the potential relationship between low T3 syndrome and PSCI in the acute phase of ischemic stroke at a 1-month follow-up visit.
In total, 314 ischemic stroke patients were consecutively enrolled in the study and followed up at 1 month. Thyroid hormones were measured within 24 hours after admission. Cognitive function was evaluated by the Mini-Mental State Exam (MMSE) 1 month after acute ischemic stroke. Cognitive impairment was defined as an MMSE score of less than 27. Cognitive impairment severity was categorized as severe, mild, or none (MMSE score <23, 23-26, or ≥27, respectively).
According to the MMSE score, 182 participants (58.0%) had cognitive impairment 1 month after stroke. Patients with low T3 syndrome were more prone to have cognitive impairment than patients with normal levels of T3 (p < 0.001). After adjusting for potential confounders in our logistic model, low T3 syndrome was independently associated with PSCI (odds ratio 4.319, 95% confidence interval 1.553-12.013, p = 0.005).
Low T3 syndrome in the acute phase of ischemic stroke was associated with a higher prevalence of 1-month PSCI, independently of established risk factors.
三碘甲状腺原氨酸（T3）低下综合征是卒中患者预后不良的预测指标。卒中后认知障碍（PSCI）是卒中后常见且重要的并发症。T3 低下综合征与 PSCI 之间的关系尚不清楚。我们旨在探讨急性缺血性卒中患者在 1 个月随访时 T3 低下综合征与 PSCI 之间的潜在关系。
共连续纳入 314 例缺血性卒中患者，并在 1 个月时进行随访。入院后 24 小时内测量甲状腺激素。急性缺血性卒中后 1 个月通过简易精神状态检查（MMSE）评估认知功能。认知障碍定义为 MMSE 评分＜27。认知障碍严重程度分为重度、轻度和无（MMSE 评分分别＜23、23-26 和≥27）。
根据 MMSE 评分，182 例（58.0%）患者在卒中后 1 个月出现认知障碍。T3 低下综合征患者比 T3 正常水平患者更易发生认知障碍（p＜0.001）。在我们的逻辑回归模型中调整潜在混杂因素后，T3 低下综合征与 PSCI 独立相关（比值比 4.319，95%置信区间 1.553-12.013，p=0.005）。
急性缺血性卒中时 T3 低下综合征与 1 个月时 PSCI 的发生率较高独立相关，与既定的危险因素无关。
