医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2015年
11期
2052-2054
,共3页
刘安民%毕桂南%童伟林%谭钰珍%廖曦
劉安民%畢桂南%童偉林%譚鈺珍%廖晞
류안민%필계남%동위림%담옥진%료희
急性脑血管病%甲状腺激素%三碘甲状腺素%四碘甲状腺素%游离三碘甲状腺原氨酸%游离四碘甲状腺原氨酸
急性腦血管病%甲狀腺激素%三碘甲狀腺素%四碘甲狀腺素%遊離三碘甲狀腺原氨痠%遊離四碘甲狀腺原氨痠
급성뇌혈관병%갑상선격소%삼전갑상선소%사전갑상선소%유리삼전갑상선원안산%유리사전갑상선원안산
Acute cerebrovascular disease%Thyroid hormone%Triiodothyronine%Thyroxine%Free triio-dothyronine%Free thyroxine
目的:探讨甲状腺功能的改变与急性脑血管病的轻重和预后转归的关系,及与年龄和美国国立卫生研究院卒中量表评分( NIHSS)的相关性。方法选择2010年10月至2012年3月广西医科大学第一附属医院神经内科收治住院的脑血管病急性期(发病72 h内)患者72例作为脑血管病组,选择同期收治的没有脑血管病及其他影响甲状腺功能的疾病的就诊者30例作为对照组。对两组进行NIHSS评分,检测甲状腺激素,对三碘甲状腺原氨酸( T3)、甲状腺素( T4)、游离三碘甲状腺原氨酸( FT3)、游离甲状腺素( FT4)、促甲状腺释放素( TSH)、NIHSS进行比较及相关性分析。结果脑血管病组NIHSS显著高于对照组[(11.38±3.47)比(0.00±0.00),P<0.05]、T3和FT3显著低于对照组[T3:(1.20±0.36) nmol/L 比(1.48±0.27) nmol/L、FT3:(3.60±0.92) pmol/L 比(4.23±0.51) pmol/L,P<0.05]。②对照组、NIHSS中分组、NIHSS高分组两两比较,T3比较差异有统计学意义,分别为(1.48±0.27)、(1.32±0.32)、(0.99±0.35)nmol/L;NIHSS中分组、NIHSS高分组 FT3显著低于对照组[(3.68±0.97),(3.46±0.82) pmol/L比(4.23±0.51) pmol/L,P<0.05]。③T3与NIHSS、年龄呈负相关,T4、FT3与NIHSS评分呈负相关,FT4和 TSH与 NIHSS、发病年龄无明显相关性。结论急性脑血管病影响甲状腺激素异常改变,以 T3、FT3下降为主。对于急性脑血管病NIHSS评分越高,T3及FT3下降越明显。年龄越大,T3下降明显。严重低 T3和T4的患者对病情严重程度有提示作用。
目的:探討甲狀腺功能的改變與急性腦血管病的輕重和預後轉歸的關繫,及與年齡和美國國立衛生研究院卒中量錶評分( NIHSS)的相關性。方法選擇2010年10月至2012年3月廣西醫科大學第一附屬醫院神經內科收治住院的腦血管病急性期(髮病72 h內)患者72例作為腦血管病組,選擇同期收治的沒有腦血管病及其他影響甲狀腺功能的疾病的就診者30例作為對照組。對兩組進行NIHSS評分,檢測甲狀腺激素,對三碘甲狀腺原氨痠( T3)、甲狀腺素( T4)、遊離三碘甲狀腺原氨痠( FT3)、遊離甲狀腺素( FT4)、促甲狀腺釋放素( TSH)、NIHSS進行比較及相關性分析。結果腦血管病組NIHSS顯著高于對照組[(11.38±3.47)比(0.00±0.00),P<0.05]、T3和FT3顯著低于對照組[T3:(1.20±0.36) nmol/L 比(1.48±0.27) nmol/L、FT3:(3.60±0.92) pmol/L 比(4.23±0.51) pmol/L,P<0.05]。②對照組、NIHSS中分組、NIHSS高分組兩兩比較,T3比較差異有統計學意義,分彆為(1.48±0.27)、(1.32±0.32)、(0.99±0.35)nmol/L;NIHSS中分組、NIHSS高分組 FT3顯著低于對照組[(3.68±0.97),(3.46±0.82) pmol/L比(4.23±0.51) pmol/L,P<0.05]。③T3與NIHSS、年齡呈負相關,T4、FT3與NIHSS評分呈負相關,FT4和 TSH與 NIHSS、髮病年齡無明顯相關性。結論急性腦血管病影響甲狀腺激素異常改變,以 T3、FT3下降為主。對于急性腦血管病NIHSS評分越高,T3及FT3下降越明顯。年齡越大,T3下降明顯。嚴重低 T3和T4的患者對病情嚴重程度有提示作用。
목적:탐토갑상선공능적개변여급성뇌혈관병적경중화예후전귀적관계,급여년령화미국국립위생연구원졸중량표평분( NIHSS)적상관성。방법선택2010년10월지2012년3월엄서의과대학제일부속의원신경내과수치주원적뇌혈관병급성기(발병72 h내)환자72례작위뇌혈관병조,선택동기수치적몰유뇌혈관병급기타영향갑상선공능적질병적취진자30례작위대조조。대량조진행NIHSS평분,검측갑상선격소,대삼전갑상선원안산( T3)、갑상선소( T4)、유리삼전갑상선원안산( FT3)、유리갑상선소( FT4)、촉갑상선석방소( TSH)、NIHSS진행비교급상관성분석。결과뇌혈관병조NIHSS현저고우대조조[(11.38±3.47)비(0.00±0.00),P<0.05]、T3화FT3현저저우대조조[T3:(1.20±0.36) nmol/L 비(1.48±0.27) nmol/L、FT3:(3.60±0.92) pmol/L 비(4.23±0.51) pmol/L,P<0.05]。②대조조、NIHSS중분조、NIHSS고분조량량비교,T3비교차이유통계학의의,분별위(1.48±0.27)、(1.32±0.32)、(0.99±0.35)nmol/L;NIHSS중분조、NIHSS고분조 FT3현저저우대조조[(3.68±0.97),(3.46±0.82) pmol/L비(4.23±0.51) pmol/L,P<0.05]。③T3여NIHSS、년령정부상관,T4、FT3여NIHSS평분정부상관,FT4화 TSH여 NIHSS、발병년령무명현상관성。결론급성뇌혈관병영향갑상선격소이상개변,이 T3、FT3하강위주。대우급성뇌혈관병NIHSS평분월고,T3급FT3하강월명현。년령월대,T3하강명현。엄중저 T3화T4적환자대병정엄중정도유제시작용。
Objective To investigate the correlation of changes of thyroid function with the severity and prognosis of patients with acute cerebrovascular disease,as well as with U.S.National Institutes of Health Stroke Scale( NIHSS) and ages of the patients.Methods A total of 72 patients with acute cerebrovascular disease(onset within 72 h) admitted in Department of Neurology,the First Affiliated Hospital of Guangxi Medical University from Oct.2010 to Mar.2012 were selected as the cerebrovascular disease group, and another 30 patients that had no cerebrovascular disease or other diseases affecting thyroid function admitted in the hospital during the same period were selected as the control group .NIHSS scores of the two groups were evaluated and compared,levels of thyroid hormones,including triiodothyronine(T3),thyroxine(T4),free trii-odothyronine ( FT3 ) , free thyroxine ( FT4 ) , thyrotropin ( TSH ) of the two groups were detected and com-pared.CorrelationbetweensuchthyroidhormonesandNIHSSwasanalyzed.Results ①NIHSSscoreofthe cerebrovascular disease group was significantly higher than the control group [(11.38 ±3.47) vs (0.00 ± 0.00),P<0.05],levels of T3 and FT3 of the cerebrovascular disease group were significantly lower than the control group [T3:(1.20 ±0.36) nmol/L vs (1.48 ±0.27) nmol/L,FT3:(3.60 ±0.92) pmol/L vs (4.23 ±0.51) pmol/L,P<0.05].②Levels of T3 in the control group,medium NIHSS score group,high NIHSS score group were respectively (1.48 ±0.27) nmol/L,(1.32 ±0.32) nmol/L and (0.99 ± 0.35) nmol/L, the differences between either two groups were statistically significant;level of FT3 in the medium NIHSS score group and high NIHSS score group the control group were significantly higher than [(3.68 ±0.97) pmol/L,(3.46 ±0.82) pmol/L vs (4.23 ±0.51) pmol/L,P<0.05].③T3 had nega-tive correlation with NIHSS and age,but T4 and FT3 had inferior correlation with NIHSS,and FT4 ,TSH had no obvious correlation with NIHSS and age.Conclusion Acute cerebrovascular disease has impact on the thyroid hormone abnormalities,which mainly presented with the decrease of T3 and FT3 levels.The higher NIHSS scores of acute cerebrovascular disease,the more significantly T3 and FT3 levels decline.The older the patients are,the more significantly T3 level decreases.Severely low levels of T3 and T4 in patients indicate the severity of the disease.