脑血管疾病患者血清甲状腺激素水平检测的临床意义

Clinical Significance of Determinations of Serum Thyroid Hormone in Cerebrovascular Disease

目的通过大样本研究了解不同类型脑血管疾病患者甲状腺激素水平的变化。方法选取4496例脑血管疾病患者,包括脑出血患者1060例、脑梗死患者3145例、头颈部动脉狭窄患者25例、短暂性脑缺血发作(transient ischemic attack,TIA)患者266例,另外选取2516名健康体检者为对照组,采用化学发光免疫分析方法,检测血清中FT3、FT4、T3、T4、TSH水平。结果脑血管疾病患者与对照组相比,FT3、FT4、T3、T4、TSH在两组之间的差异均有统计学意义。脑血管疾病患者血清FT3、T3、T4、TSH水平低于对照组,FT4高于对照组。将脑血管疾病患者进一步分为脑出血组、脑梗死组、头颈部动脉狭窄组及TIA组等4组,与对照组一起比较,FT3、FT4、T3、T4、TSH在5组之间的差异均有统计学意义。FT3、T3、TSH在各组中位数均为脑出血组<脑梗死组<头颈部动脉狭窄组<TIA组,FT4在各组中位数为脑出血组>脑梗死组>TIA组>头颈部动脉狭窄组,T4在各组中位数为脑出血组>脑梗死组>头颈部动脉狭窄组>TIA组。结论甲状腺激素水平变化可反映不同类型脑血管患者病情严重程度,是辅助诊断的重要指标。

Objective To investigate the levels of thyroid hormones in different kinds of cerebrovascular disease patients by large sample study. Methods 4496 serum samples from the cerebrovascular disease patients were collected,including 1060 serum samples from cerebral hemorrhage patients,3145 serum samples from cerebral infarction patients ,25 serum samples from head and neck arterystenosis patients, and 266 serum samples from transient ischemic attack（TIA） patients. 2516 serum samples from the health check-up people were collected as the control group. The levels of serum free triiodothyronine （ PT3 ）, free thyroxine （ FT4 ）, triiodothyronine （ T3 ）, thyroxine （ T4 ） and thyrotropic- stimulating hormone （ TSH ） were detected by chemiluminescence immunoassay method. Results The levels of serum FT3, FT4, T3, T4, TSH between patients with cerebrovascular disease and healthy individuals were significantly different. The levels of PT3, T3, T4, TSH in cerebrovascular disease patients were lower than the control group, and the level of FT4 in cerebrovascular disease patients was higher than the control group. The cerebrovascular disease patients were divided into 4 groups including cerebral hemorrhage group, cerebral infarction group, head and neck artery stenosis group and TIA group. Compared with control group,the levels of serum FF3, FT4, T3 , T4, TSH were significantly different among the 5 groups. The median of serum FT3 ,FT3 ,TSH levels were cerebral, hemprrhage group 〈cerebral infarction group 〈 head and neck artery stenosis group 〈 TIA group, and the median of FT4 levels was cerebral hemorrhage group 〉 cerebral infarction group 〉 TIA group 〉 head and neck artery stenosis group, and the median of T4 levels was cerebral hemorrhage group 〉 cerebral inaction group〉 head and neck artery stenosis group 〉 TIA group. Conclusion The changes in ,thyroid hormones can reflect the severity of the cerebrovascular disease, and is an important auxiliary diagnosis index.