Chen Zhongyun, Sun Yijia, Zhang Yingbo, He Yanbo, Chen Hongbo, Su Yingying
Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China.
Department of Neurology, Beijing Tsinghua Changgung Hospital, Tsinghua University, No. 168, Litang Road, Changping District, Beijing, 102200, China.
Neurol Sci. 2020 Jul;41(7):1821-1828. doi: 10.1007/s10072-020-04281-0. Epub 2020 Feb 13.
To determine the correlation of thyroid hormone status with hemorrhagic transformation (HT) and short-term clinical outcomes in patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT) METHODS: A retrospective analysis was conducted on AIS patients who underwent EVT at our hospital from 2016 to 2019. Thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), and free thyroxine (FT4) levels were assessed, and logistic regression analyses were performed with HT incidence and functional outcome at 3 months.
A total of 199 patients (148 males; mean age 62.9 ± 13.1 years) were included in the study. The number of patients with HT and unfavorable functional outcomes at 3 months were 74 (37.2%) and 129 (64.8%), respectively. Multiple logistic regression analysis showed that low TSH level (OR = 0.609; 95% CI 0.402-0.920, 푃 = 0.019) was an independent risk factor of poor functional outcome, while none of the thyroid hormones were significantly associated with HT risk. The optimal cutoff value of TSH that best distinguished both unfavorable outcome (sensitivity 31%, specificity 88.6%, area under the curve (AUC) 0.586) and mortality at 3 months (sensitivity 47.4%, specificity 78.3%, AUC 0.606) was 0.485 uIU/ml.
A lower TSH value upon admission may predict an unfavorable functional outcome in AIS patients after EVT, but thyroid hormone levels have no bearing on the risk of HT.
确定血管内血栓切除术（EVT）后急性缺血性卒中（AIS）患者甲状腺激素状态与出血性转化（HT）及短期临床结局的相关性。方法：对2016年至2019年在我院接受EVT的AIS患者进行回顾性分析。评估促甲状腺激素（TSH）、总三碘甲状腺原氨酸（TT3）、游离三碘甲状腺原氨酸（FT3）、总甲状腺素（TT4）和游离甲状腺素（FT4）水平，并对3个月时的HT发生率和功能结局进行逻辑回归分析。
本研究共纳入199例患者（148例男性；平均年龄62.9±13.1岁）。3个月时发生HT和功能结局不良的患者数量分别为74例（37.2%）和129例（64.8%）。多因素逻辑回归分析显示，低TSH水平（OR = 0.609；95%CI 0.402 - 0.920，P = 0.019）是功能结局不良的独立危险因素，而甲状腺激素均与HT风险无显著相关性。能最佳区分不良结局（敏感性31%，特异性88.6%，曲线下面积（AUC）0.586）和3个月死亡率（敏感性47.4%，特异性78.3%，AUC 0.606）的TSH最佳截断值为0.485 uIU/ml。
入院时较低的TSH值可能预示EVT后AIS患者功能结局不良，但甲状腺激素水平与HT风险无关。
