中青年急性缺血性脑卒中患者甲状腺过氧化物酶抗体与远期神经功能的关系

The relationship between thyroid peroxidase and long-term neurological function in young and middle-aged patients with acute ischemic stroke

目的分析低甲状腺过氧化物酶抗体与中青年急性缺血性脑卒中患者远期功能预后的相关性。方法选择2017年4月~2019年2月我院神经内科收治的中青年急性缺血性脑卒中患者148例,年龄18~64岁。根据脑卒中发病后1年患者的神经功能结局分为预后良好组(n=104)和预后不良组(n=44)。比较两组临床资料,以多因素Logistic回归法分析低T3综合征与急性缺血性脑卒中远期功能预后的相关性。结果与预后良好组比较,预后不良组糖尿病比例、中重度神经功能缺损比例、甲状腺过氧化物酶阳性比例明显更高(P<0.05),而FT3水平则明显更低(P<0.05)。甲状腺过氧化物酶阳性是中青年急性缺血性脑卒中患者远期不良预后的独立危险因素[OR=9.128,95%CI(2.246,10.548),P=0.008]。结论甲状腺过氧化物酶抗体水平可预测中青年急性缺血性脑卒中患者远期功能预后转归。

Objective To analyze the correlation between low thyroid autoantibodies and long-term functional prognosis of young and middle-aged patients with acute ischemic stroke.Methods A total of 148 young and middleaged patients with acute ischemic stroke admitted to the department of neurology of our hospital from Apr 2017 to Feb 2019.According to the neurological outcome of patients 1 year after the onset of stroke,patients were divided into good prognosis group(n=104)and poor prognosis group(n=44).The clinical data of the two groups were compared,and the correlation between long-term functional prognosis of patients with low T3 syndrome and acute ischemic stroke was analyzed by multivariate logistic regression analysis.Results Compared with good prognosis group,the proportion of diabetes,the proportion of moderate to severe neurological deficits,the proportion of thyroid peroxidase positive and the baseline NIHSS score were significantly higher than the poor prognosis group(P<0.05),while the FT3 level was significantly lower(P<0.05).Positive thyroid peroxidase was an independent risk factor for long-term poor prognosis of young and middle-aged patients with acute ischemic stroke[OR=9.128,95%C(I 2.246,10.548),P=0.008].Conclusion Thyroid peroxidase antibody level can predict the long-term functional prognosis of young and middle-aged patients with acute ischemic stroke.