亚临床甲状腺功能减退症与急性缺血性卒中患者转归的相关性

Correlation between subclinical hypothyroidism and outcomes of patients with acute ischemic stroke

目的探讨亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)与急性缺血性卒中患者临床转归的相关性。方法回顾性纳入2014年7月至2017年10月南京医科大学附属江苏盛泽医院收治的急性缺血性卒中患者。收集患者人口统计学以及基线临床和实验室检查资料。在发病后3个月时采用改良Rankin量表评价临床转归,≤2分定义为转归良好。应用多变量logistic回归分析确定SCH与急性缺血性卒中患者临床转归的独立相关性。结果共纳入200例急性缺血性卒中患者。其中,男性107例(53.5%),女性93例(46.5%);年龄(69.67±11.38)岁。45例患者(22.5%)存在SCH;160例(80.0%)转归良好,40例(20.0%)转归不良。单变量分析显示,转归不良组基线美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分以及卒中病因学分型和SCH患者构成比与转归良好组差异有统计学意义(P均<0.05)。多变量logistic回归分析显示,高NIHSS评分(优势比2.884,95%置信区间2.005~4.147;P=0.001)和SCH(优势比19.527,95%置信区间2.334~163.386;P=0.006)是转归不良的独立危险因素。结论高NIHSS评分和SCH与急性缺血性卒中患者发病后3个月时转归不良相关。

Objective To investigate the correlation between subclinical hypothyroidism(SCH)and clinical outcomes of patients with acute ischemic stroke.Methods From July 2014 to October 2017,patients with acute ischemic stroke admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University were enrolled retrospectively.Their demographic and baseline clinical and laboratory data were collected.The modified Rankin Scale was used to evaluate the clinical outcome at 3 months after the onset of symptoms.Multivariate logistic regression analysis was used to determine the independent correlation between SCH and clinical outcome of patients with acute ischemic stroke.Results A total of 200 patients with acute ischemic stroke were enrolled,including 107 males(53.5%)and 93 females(46.5%).Their age was 69.67±11.38 years.There were 45 patients(22.5%)with SCH,160(80.0%)with good outcomes,and 40(20.0%)had poor outcomes.Univariate analysis showed that there were significant differences in the baseline National Institutes of Health Stroke Scale(NIHSS)score,stroke etiology classification and the proportion of patients with SCH between the poor outcome group and the good outcome group(all P<0.05).Multivariate logistic regression analysis showed that high NIHSS score(odds ratio 2.884,95%confidence interval 2.005-4.147;P=0.001)and SCH(odds ratio 19.527,95%confidence interval 2.334-163.386;P=0.006)were the independent risk factors for poor outcomes.Conclusion High NIHSS score and SCH were associated with the poor outcomes at 3 months after the onset of acute ischemic stroke.