| 张 丹,刘翠梅,徐志强,冷翠花,杨玲俐.抗甲状腺过氧化物酶抗体水平与缺血性卒中患者颅内大动脉狭窄发生和短期转归的关系[J].,2017,17(15):2847-2852 |
| 抗甲状腺过氧化物酶抗体水平与缺血性卒中患者颅内大动脉狭窄发生和短期转归的关系 |
| The Relationship between Serum Level of Anti-thyroid Peroxidase Antibody and the Intracranial Large Artery Stenosis and Short-term Outcome of Patients with Acute Ischemic Stroke |
| 投稿时间：2016-12-11 修订日期：2016-12-28 |
| DOI：10.13241/j.cnki.pmb.2017.15.012 |
| 中文关键词: 卒中 脑缺血 抗甲状腺过氧化物酶抗体 颅内大动脉脉狭窄 |
| 英文关键词: Stroke Brain Ischemia Anti- thyroid peroxidase anti-body Intracranial large artery stenosis |
| 基金项目:国家自然科学基金项目（81200893） |
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| 中文摘要: |
| 摘要 目的：探讨急性缺血性卒中患者血清抗甲状腺过氧化物酶抗体水平与患者颅内大动脉血管有无狭窄和短期转归的关系。方法：回顾性分析225例急性缺血性卒中患者的临床资料，根据颅脑MRA、颅脑CTA及DSA结果，将卒中患者分为颅内大动脉分为血管狭窄组(n=146)和非狭窄组(n=79)，并将狭窄组按狭窄程度分为1-6组，每组代表一个等级。在入院24 h内检测血清抗甲状腺过氧化物酶抗体、同型半胱氨酸、C-反应蛋白、尿酸、甲功、血脂、血糖等生化指标，入院当天采用美国国立卫生研究院卒中量表(NIHSS)评定神经功能缺损情况。在出院时或发病后14 d，采用改良Rankin量表(mRS)评估临床转归。结果：颅内大动脉血管狭窄组血清抗甲状腺过氧化物酶抗体水平显著高于非狭窄组(P＜0.01)。血清抗甲状腺过氧化物酶抗体(TPO-Ab)[优势比(odds ratio, OR)1.003，95％可信区间(confidence interval, CI)(1.001～1.005)；P＜0.05]水平升高是脑梗死患者血管狭窄的独立危险因素。入院时血清抗甲状腺过氧化物酶抗体水平升高与短期转归不良有关(P＜0.01)，但校正其他混杂因素后丧失统计学意义(OR： 0.998，95％ CI：0.993~1.002；P >0.05。结论：急性缺血性卒中患者血清抗甲状腺过氧化物酶抗体水平是脑梗死患者血管狭窄的独立危险因素，但与血管狭窄组狭窄程度及短期转归无关短期转归无关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum level of anti -thyroid peroxidase anti-body and patients with intracranial large artery stenosis and the short-term outcome in patients with acute ischemic stroke. Methods: A retrospective consecutive 225 patients with acute ischemic stroke were enrolled according to the clinical data of brain MRA and brain CTA and DSA results, the patients were divided into intracranial large artery stenosis group (ILAS) (n=146) and non stenosis group (non-ILAS) (n=79). The steno- sis group was divided into 1-6 group according to the degree of stenosis, each group represents one grade. The biochemical indicators, such as serum anti- thyroid peroxidase anti-body, homocysteine, C- reactive protein, uric acid, thyroid function, and blood glucose w ere measured with 24 h after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the neurological deficits on the day of admission. The NIHSS score <8 was defined as mild stroke and ≥8 was defined as moderate to severe stroke. At discharge or 14 d after onset, the modified Rankin Scale (mRS) was used to evaluate the clinical outcomes, 0-2 was defined as good outcome and > 2 was defined as poor outcome. Results: The levels of serum anti -thyroid peroxidase anti-body in the intracranial large artery stenosis group were significantly higher than those in the none stenosis group (P<0.01). Multivariate logistic regression analysis showed that ele- vated levels of serum anti -thyroid peroxidase antibody (TPO-Ab) [odds ratio (odds ratio OR) 1.003, 95% confidence interval (confi- dence, interval, CI) (1.001 ~ 1.005); P<0.05] was an independent risk factor of the intracranial large artery stenosis group(ILAS). Univari- ate analysis showed that admission serum anti -thyroid peroxidase anti-body levels were associated with short-term outcome (P<0.01), but after adjustment for other confounding factors，there was no statistical significance (OR: 0.998, 95% CI: 0.993~1.002, P>0.05). Conclusion: The serum anti -thyroid peroxidase anti-body was an independent risk factor in acute ischemic stroke patients with with in- tracranial large artery stenosis, but it was not associated with short-term outcome. |
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