血清甲状腺抗体水平上升与脑梗死分型以及血管狭窄分布之间的关系

Prediction of cerebral infarction type and distribution of vascular stenosis by serum thyroid antibody level

目的研究血清甲状腺抗体水平上升与脑梗死分型及血管狭窄分布之间的关系。方法采用回顾性分析方法,以2018年1月至2021年1月沈阳市第七人民医院收治入院的228例脑梗死患者为研究对象,根据甲状腺抗体是否正常分为对照组(甲状腺抗体水平正常,n=178)与研究组(甲状腺抗体水平升高,n=50)。通过头部磁共振血管造影、磁共振成像、CT血管造影和全脑血管造影比较两组患者脑梗死分型及血管狭窄分布特征,分析甲状腺抗体[促甲状腺素受体抗体(TRAb)、抗甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)]水平上升与脑梗死分型及血管狭窄分布之间的关系。结果脑梗死分型中,研究组心源性栓塞者占比(22.00%)明显高于对照组(9.55%),差异有统计学意义(P<0.05);小动脉闭塞者占比(36.00%)明显高于对照组(21.35%),差异有统计学意义(P<0.05);闭塞或狭窄颅外动脉者占比(1.01%)明显低于对照组(14.94%),差异有统计学意义(P<0.05);椎动脉颅内段占比(3.00%)明显高于对照组(0.56%),差异有统计学意义(P<0.05)。校正所有变量后,甲状腺抗体水平升高是小动脉闭塞、心源性栓塞的独立预测因子。结论脑梗死患者的甲状腺抗体升高后,其小动脉闭塞、心源性栓塞及椎动脉颅内段闭塞或狭窄发生风险更高,颅外动脉闭塞或狭窄发生风险更低。

Objective To study the relationship between the increase of serum thyroid antibody level and the type of cerebral infarction and the distribution of vascular stenosis.Methods A retrospective analysis was performed on 228 patients with cerebral infarction admitted to the Seventh People's Hospitalof Shenyang from January 2018 to January 2021.According to whether thyroid antibody was normal,they were divided into control group(n=178)and study group(n=50).Thyroid antibody was normal in the control group,but increased in the study group.The classification of cerebral infarction and the distribution of vascular stenosis were compared between the two groups.Results The incidence of cardiac embolism in the study group(22.00%)was lower than that in the control group(9.55%),and the difference was statistically significant(P<0.05).Small artery occlusion in the study group(36.00%)was higher than that in the control group(21.35%),the difference was statistically significant(P<0.05).The proportion of patients with occlusion or stenosis of extracranial arteries in the study group(1.01%)was significantly lower than that in the control group(14.94%),and the difference was statistically significant(P<0.05).The proportion of the intracranial segment of the vertebral artery in the study group(3.00%)was significantly higher than that in the control group(0.56%),and the difference was statistically significant(P<0.05).After adjustment for all variables,elevated thyroid antibodies were an independent predictor of small artery occlusion and cardiogenic embolism.Conclusion The risk of small artery occlusion,cardiogenic embolization and intracranial vertebral artery occlusion or stenosis is higher in patients with cerebral infarction with increased thyroid antibody,and the risk of extracranial artery occlusion or stenosis is lower.