Akhoundzadeh Kobra, Zarvani Ashraf, Mohajerani Fatemeh, Shafia Sakineh
Department of Physiology, Qom University of Medical Sciences, Qom, Iran.
Department of Neurology, Mazandaran University of Medical Sciences, Sari, Iran.
Heliyon. 2025 Jan 11;11(2):e41921. doi: 10.1016/j.heliyon.2025.e41921. eCollection 2025 Jan 30.
Despite plenty of studies on the change in thyroid hormones after stroke, there is still no consensus for a comprehensive conclusion and clinical application. This pilot study aimed to investigate the change in thyroid hormones and its association with neurological impairments during the first two days after the stroke. This was a cross-sectional descriptive and analytical study. Neurological deficits were assessed using the National Institutes of Health Stroke Scale (NIHSS). In addition, blood samples were collected for TSH, T and T. P value < 0.05 was considered significant. Fifty patients (42 % men) with a mean age of 69.73 (SD ± 12.31) were included. The majority of patients had a high level of TSH and T, and a normal level of T on the first and second days of hospitalization. 33.3 and 20.9 percent of patients had NIHSS scores >10 on the first and second day respectively. According to the multivariate analysis, high T hormone was as a predictor of NIHSS score >10. There was no association between thyroid hormones and NIHSS at the admission. In addition, there was no relationship between thyroid hormones and TSH on the second day. According to the results, stroke affects the levels of thyroid hormones and the pituitary-thyroid axis. Because of the diversity in results of existing studies, further clinical research with the same methodology and data analysis is needed to find consistent results on the association between thyroid hormones and neurological impairments. Monitoring thyroid status in stroke patients may be recommendable.
尽管针对中风后甲状腺激素变化进行了大量研究,但对于全面结论及临床应用仍未达成共识。这项初步研究旨在调查中风后头两天甲状腺激素的变化及其与神经功能缺损的关联。这是一项横断面描述性和分析性研究。使用美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损。此外,采集血样检测促甲状腺激素(TSH)、总三碘甲状腺原氨酸(T₃)和总甲状腺素(T₄)。P值<0.05被认为具有统计学意义。纳入了50例患者(42%为男性),平均年龄为69.73岁(标准差±12.31)。大多数患者在住院第一天和第二天时促甲状腺激素和总三碘甲状腺原氨酸水平较高,总甲状腺素水平正常。分别有33.3%和20.9%的患者在第一天和第二天NIHSS评分>10分。根据多变量分析,高总三碘甲状腺原氨酸水平是NIHSS评分>10分的一个预测因素。入院时甲状腺激素与NIHSS之间无关联。此外,第二天甲状腺激素与促甲状腺激素之间也无关系。根据研究结果,中风会影响甲状腺激素水平及垂体-甲状腺轴。由于现有研究结果存在差异,需要采用相同方法和数据分析进行进一步临床研究,以找到关于甲状腺激素与神经功能缺损之间关联的一致结果。建议对中风患者的甲状腺状态进行监测。