大动脉粥样硬化性脑梗死患者伴发低三碘甲状腺原氨酸综合征的危险因素及预后分析

Analysis of risk factors and prognosis in patients with cerebral infarction due to large artery atherosclerosis combined with low triiodothyronine syndrome

目的探讨大动脉粥样硬化性脑梗死（LAA-CI）患者伴发低三碘甲状腺原氨酸（T3）综合征（LTS）的危险因素及预后。方法对208例急性LAA-CI患者进行甲状腺激素水平检测并分组。采集患者相关临床资料。随访1年时进行mRS评分。对结果进行统计分析。结果本组T3正常患者151例（对照组）,LTS患者57例（LTS组）。LTS组患者T3水平显著低于对照组患者,促甲状腺激素水平显著高于对照组患者（均P〈0.01）。LTS组患者年龄、收缩压、入院时NIHSS评分及糖尿病的比例明显高于对照组（均P〈0.05）。Logistic回归分析显示,年龄、入院时NIHSS评分与LTS的发生密切相关（均P〈0.01）。LTS组患者1年后mRS评分3-6分及6分的比例明显高于对照组（均P〈0.01）。结论 LAA-CI患者伴发LTS预后较差,高龄及神经功能缺损严重可能是其独立危险因素。

Objective To explore the risk factors and the prognosis in cerebral infarction due to large artery atherosclerosis（ LAA-CI） patients combined with low triiodothyronine（ T3） syndrome（ LTS）. Methods Two hundred and eight patients with acute LAA-CI were divided into two groups based on examined thyroid hormone levels. Clinical data on admission and mRS at one year after the event were collected and analyzed. Results There were 151 cases of patients with normal T3levels（ control group） and 57 cases of patients with LTS（ LTS group）.Compared with patients in control group,the T3 level of LTS group was significantly decreased,while the thyroid stimulating hormone level was significantly increased（ all P〈0. 01）. Age,systolic blood pressure,NIHSS score on admission and proportion of patients with diabetes mellitus in LTS group were significantly higher than those in control group（ all P〈0. 05）. Logistic regression analysis showed that age and NIHSS on admission were closely related with incidence of LTS（ all P〈0. 01）. The proportion of patients with mRS 3- 6 or 6 at one year after the event in LTS group was significantly higher than that in control group（ all P〈0. 01）. Conclusions The prognosis of LAA-CI patients combined with LTS is poor. Aged and severe neurological deficits may be the independent risk factors of which.