进展性缺血性卒中患者甲状腺素水平监测的临床意义

Clinical significance of monitoring thyroxine level in patients with progressive ischemic stroke

目的探讨进展性缺血性卒中的相关危险因素与进展性卒中患者甲状腺素水平监测的意义.方法回顾性分析我院神经内一科2016年8月~2017年7月期间住院的230例急性脑梗死患者,根据有无病情进展分为进展组47例与非进展组183例,采用多因素Logistic回归分析确定进展性卒中的危险因素.结果 47例进展组中合并高血压病者37例,占78.7%;合并感染者24例,占51.1%.183例非进展组中合并高血压病者114例,占62.3%,合并感染者占27例,占14.8%,差异均有统计学意义(P<0.05).进展组具有较低的FT3水平(t=4.227,P<0.001)及较高的FT4水平(t=-7.153,P<0.001),差异具有统计学意义.多变量Logistic回归分析显示合并感染及较高的FT4水平在两组间有统计学差异(P<0.05).结论进展性卒中患者血清FT4水平显著高于非进展性卒中患者,FT4是进展性卒中的独立危险因素,早期监测甲状腺素水平有助于判断病情进展及预后,合并感染是进展性卒中另一个独立的危险因素,临床上应予以重视.

Objective To discuss the related risk factors of progressive ischemic stroke, focusing on explaining the clinical significance of monitoring thyroxine level in patients with progressive ischemic stroke. Methods 230 acute cerebral infarction patients distributed into progressive and non-progressive group were allowed into the study. All patients were admitted to hospital between August 2016 and July 2017. Risk factors, imaging material and other clinical data associated with cerebrovascular disease were also collected. The major risk factors of progressive ischemic stroke were analyzed. Results In 47 cases of progressive ischemic stroke group, 37 cases had the history of hypertension, accounted for 78.7%. Meanwhile, 24 cases had infection(51.1%). In 183 cases of non-progressive group, 114 cases had the history of hypertension which accounted for 62.3%, 27 cases had pulmonary infection(14.8%). There were significant differences between two groups(P<0.05). Compared to the non-progressive group, progressive group had a lower level of FT3(t=4.227, P<0.001) and higher FT4 level(t=-7.153, P<0.001).The multivariate logistic regression analysis results showed that co-infection and a higher level of FT4 were independent risk factors of progressive ischemic stroke(P<0.05).Conclusion Serum FT4 level in the group of progressive stroke is significantly higher than that of in the group of non-progressive stroke. FT4 is an independent risk factor for progressive stroke. Early monitoring of thyroxine levels can help predict disease progression and prognosis. Concurrent infection is another independent risk factor of progressive stroke.