Correlation between subclinical hypothyroidism and early neurological deterioration in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2017.09.004
- VernacularTitle:亚临床甲状腺功能减退症与急性缺血性卒中患者早期神经功能恶化的相关性
- Author:
Chaogang ZHAO
1
;
Wenxue WANG
;
Qiang SU
;
Xiaolan LI
;
Dezhi LIU
Author Information
1. 272000,济宁市中西医结合医院神经内科
- Keywords:
Stroke;
Brain Ischemia;
Hypothyroidism;
Disease Progression;
Risk Factors
- From:
International Journal of Cerebrovascular Diseases
2017;25(9):800-804
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between subclinical hypothyroidism (SCH) and early neurological deterioration (END) in patients with acute ischemic stroke.Methods The consecutive inpatients with first-ever acute ischemic stroke were enrolled.SCH was defined as thyroid stimulating hormone ＞ 5.0 mU/L and thyroid function was normal.END was defined as an increase of ≥ 1 point in motor power or an increase of ≥ 2 points in the total National Institute of Health Stroke Scale (NIHSS) score within 7 days.Univariate analysis was used to compare the differences in baseline data between END group and non-END group,multivariable logistic regression analysis was used to determine the independent correlation between SCH and END in acute ischemic stroke.Results A total of 198 patients were enrolled,48(24.2％) with END.The age (67.1± 8.5 yearsvs.63.9± 9.0 years;t=2.169,P=0.031),homocysteine level (15.1 ± 5.6 μmol/L vs.13.2 ± 4.5 μmol/L;t =2.353,P =0.020),high-sensitive C-reactive protein (median and interquartile range,5.5 [1.7-8.7] g/L vs.2.9[1.0-5.0] g/L;Z =2.765,P =0.006),baseline NIHSS score (4.0[6.0-8.0] vs.4.0[2.0-6.0];Z=2.681,P=0.007),and the proportion of patients with diabetes mellitus (29.2％ vs.16.0％;x2 =4.065,P =0.044)) in the END group were significantly higher than those in the non-END group,and the proportion of patients with SCH (10.4％ vs.28.7％;x2 =4.086,P=0.043) was significantly lower than that of the non-END group.Multivariate logistic regression analysis indicated that SCH was an independent protective factor for END in acute ischemic stroke after adjusted for age,sex and other potential confounders (odd ratio 0.221;95％ confidence interval 0.055-0.801;P =0.022).Conclusions The END risk is lower in acute ischemic patients with SCH.
