脑梗死患者下丘脑-垂体-甲状腺轴功能变化的临床观察

Clincal observation of hypothalamic-pituitary-thyroid axis function changes in patients with cerebral infarction

目的:探讨脑梗死对下丘脑-垂体-甲状腺轴功能的影响。方法:研究对象按是否患脑梗死分为两组,即脑梗死组、正常对照组。用放射免疫法检测血清中游离三碘甲状原氨酸(FT3)、游离甲状腺素(T4)、促甲状腺素(TSH),采用独立样本t检验比较各组间差异。结果:脑梗死组(急性期)与正常对照组相比,血清中FT3水平显著下降,有显著性差异(P<0.01);血清TSH水平明显升高,有显著性差异(P<0.01)。脑梗死组(恢复期)与正常对照组相比,血清中FT3水平显著回升,无明显差异(P>0.05);血清TSH水平明显降低,无明显差异(P>0.05)。结论:本研究提示脑梗死急性期存在垂体-甲状腺轴功能变化,出现低T3高TSH综合征,随着病情的好转逐渐恢复。

Objective： To investigate the changes on hypothalamic-pituitary-thyroid axis function in acute cerebral infarction patients. Methods： T-test was used to compare the level of serum FT3, T4, TSH in 60 acute cerebral infarction patients and 40 control subjects. Results： Compared with the control group, the serum FT3 decreased significantly（P〈0.01） while the level of serum TSH increased（P〈0.01）in cerebral infarction patients during acute period. However, during recoverable period the level of FT3 in cerebral infarction cases raised again and serum TSH fall. Compared with the control group, there was no significant difference in the level of FT3 and TSH （P〉0.05）. Conclusion：During acute period of cerebral infarction, low T3 and high TSH syndrome appeared with the change of hypothalamic-pituitary-thyroid axis function. Serum T3 and TSH can be the strongest predictors for the grade of illness and short-term outcome in patients with acute cerebral infarction.