急性脑血管患者甲状腺激素水平的变化对临床的诊治意义

Clinical Diagnosis and Treatment Significance of Changes of Thyroid Hormones Levels of Patients with Acute Cerebrovascular Disease

目的探讨甲状腺激素水平变化对急性脑血管病的临床诊治意义。方法整群选取2014年1月—2016年1月在急性发病48 h内被该院收治的患者急性脑血管病患者247例作为研究对象,分为脑梗死组与脑出血组,并选同期体检健康志愿者272名为对照组,比较患者与对照的激素水平,以及不同病情的患者治疗疗效。结果治疗前,全部患者的T3、T4、FT3、FT4、TSH水平与对照组比较差异有统计学意义(P<0.01);经治疗后,脑梗死组患者的T3水平为(2.01±0.67)nmol/L,T4水平为(107.61±25.09)nmol/L,FT3水平为(4.87±0.96)pmol/L,FT4水平为(14.22±3.83)pmol/L;脑出血组患者的T3水平为(2.15±0.59)nmol/L,T4水平为(111.78±26.04)nmol/L,FT3水平为(5.14±1.09)pmol/L,FT4水平为(14.14±3.91)pmol/L,均有不同水平上升;脑梗死组患者TSH为(2.34±0.99)μIU/m L,脑出血组患者TSH水平为(2.55±1.01)μIU/m L,均有不同水平的下降;轻型组患者的T3、T4、FT3、FT4、TSH水平与对照组比较差异无统计学意义,而从总体来说,病情轻的患者恢复程度较好,基本恢复至正常水平。结论甲状腺激素的水平变化可以反映急性脑血管患者病情改变的情况,具有临床诊治意义。

Objective To study the clinical diagnosis and treatment significance of changes of thyroid hormones levels of patients with acute cerebrovascular disease. Methods Group selection 247 cases of patients with acute cerebrovascular disease from January 2014 to January 2016 were selected and divided into the cerebral infarction group and hematencephalon group, and 272 cafse of the healthy physical examination people were selected as the control group, and the hormone level of the two groups was compared and the treatment curative effect was observed. Results Before treatment, the differences in the T3,T4,FT3,FT4,TSH levels had statistical significance(P<0.01), after treatment, the T3, T4,FT3,FT4 levels of the two groups increased at different levels, and TSH level of the two groups decreased at differnet levels, [(2.01 ±0.67)nmol/L,(107.61±25.09)nmol/L,(4.87±0.96)pmol/L,(14.22±3.83)pmol/L,(2.34±0.99)μIU/m L vs(2.15±0.59)nmol/L,(111.78±26.04)nmol/L,(5.14±1.09)pmol/L,(14.14 ±3.91)pmol/L,(2.55 ±1.01)μIU/m L], but in general, the recovery degree of patients with mild disease was good, and returned to the normal level basically. Conclusion The changes of thyroid hormones levels can reflect the disease changes of patients with acute cerebrovascular disease, which is of clinical diagnosis and treatment significance.