急性脑梗死患者甲状腺激素变化及其临床意义

Clinical significance and changes of serum thyroid hormones levels in patients with acute cerebral infarction

目的探讨急性脑梗死患者甲状腺激素水平的变化及其临床意义。方法采用化学发光法检测65例急性脑梗死患者治疗前后和50例健康对照者血清三碘甲状腺原氨(T3)、游离三碘甲状腺原氨(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平,并对2组进行比较。结果甲状腺激素水平T4、FT4、TSH在治疗前后各组与对照组相比差异无统计学意义(P>0.05)。T3在治疗前较对照组明显降低(P<0.05),FT3治疗前与对照组相比降低更显著(P<0.01),在治疗后T3、FT3与对照组相比差异无统计学意义(P>0.05)。结论脑梗死患者急性期的保护性应激反应可引起T3和FT3下降,并且T3和FT3的降低与病情严重程度及预后密切相关,随着病情好转逐渐恢复;对于治疗前后甲状腺激素水平的变化,有助于监测治疗和判断预后有一定临床意义。

Objective To investigate the clinical significance of alteration of serum thyroid hormone levels in patients with acute cerebral infarction （ACI）. Methods Serum triiodothyronine （T3）, free serum triiod-othyronine （FT3）, thyroxine （T4）, free thyroxine （FT4） and thyroiddstimu-lating hormone（TSH） were detected by chemoluminescence assay in 65 cases of ACI before and after treatment as well as 50 normal controls, and the results were compared. Results There were no significant changes in T4, FT4 and TSH between ACI team before and after treatment and controls （P〈0.05）. T3 and FT3 levels were lower in patients before treatment than those of controls （P〈0.05）. FTa levels were greatly lower for patients before treat- ment than those of controls （P〈0.01）. There were no significant changes in T3 , FT3 between ACI team after treatment and controls （P〉0.05）. Conclusion Decrease of serum Ta and FT3 levels are present in acute period in patients with ACI, and serum Ta and FT3 levels are closely related with disease severity and outcome prediction. It has clinical significance for detecting treatment and determining outcome prediction.