摘要
目的：探讨动态监测甲状腺激素对中风急症患者病势演变判断的临床意义。方法：采用放射免疫分析法（ＲＩＡ）测定４２例脑卒中患者入院初、出院前和临终时三碘甲状腺原氨酸（Ｔ３）、甲状腺素（Ｔ４）、促甲状腺激素（ＴＳＨ）含量和Ｔ３／ｒＴ３比值，并与６０例正常对照组作比较。结果：好转组（由中脏腑顺转为中经络至康复）入院时Ｔ３、Ｔ４、ｒＴ３和ＴＳＨ值均较正常对照组有明显差异（Ｐ均＜０．０５），并随着治疗的康复，此种变化逐渐恢复，与正常对照组比较Ｐ＞０．０５；恶化组（由中脏腑或中经络逆转为中脏腑至死亡）入院即呈明显“低Ｔ３血症”，ｒＴ３直线型升高；Ｔ３／ｒＴ３比值与病情严重程度成正比，好转组此比值可逐渐升高至２．００以上，恶化组逐渐下降至１．００以下，临终时Ｔ３／ｒＴ３比值＜０．５０。结论：动态检测脑卒中患者血清甲状腺激素水平变化对判断患者证候、病情、病势的微观辨证和转归具有重要的临床价值。
Objective:To explore the clinical significance of dynamic monitoring thyroid hormone in judgement of disease development in patients with stroke.Methods:The level of triiodothyronine(T3),thyroxin (T4),thyroid stimulating hormone (TSH) and T3/rT3 ratio were detected by radioimmunoassay (RIA) in 42 cases of cerebral stroke at early stage of hospitalization,predischarged from hospital and critical days respectively,and compared to 60 cases of normal subjects (control group).Results:In improvement group 〔from Zhong Zangfu by direct motion through Zhong Jingluo to recovery〕,T3,T4,rT3 and TSH values were obvious difference in compared to control group (all P<005),but they were recovered gradually along with curative process,there were no significent differences compared to control group (P>005);in deteriorate group (from Zhong Zangfu or Zhong Jingluo by retrograde motion to died),serum T3 value was decreased obviously at the early stage of hospitalization;rT3 was raised sharply;T3/rT3 ratio was correlated positively with severity of disease,the ratio value can raise over “2” in improvement group;while it was fell gradually to below “1” in deteriorate group or “05” at critical time.Conclusions:There have important clinical significance of dynamic monitoring the changes in serum thyroid hormone to judge the signs,symptoms disease development,differentiation,typing and prognosis etc.
