急性脑梗死患者甲状腺功能异常的临床研究

发布时间：2018-07-10 17:20

本文选题：脑梗死 + 甲状腺功能异常　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:观察急性脑梗死患者甲状腺功能异常的发生率及其对脑梗死危险因素的影响,探讨甲状腺功能异常在急性脑梗死发生发展中的可能作用。方法:收集2015年7月到2016年6月在吉林大学第二医院神经内科住院治疗的新发脑梗死病例。对患者进行既往史、烟酒史询问,行血液化验、颈部血管彩超等检查。根据甲状腺功能将294例新发脑梗死患者分为甲亢组(包括临床甲亢和亚临床甲亢)、甲减组(包括临床甲减和亚临床甲减)和甲功正常组。分析比较各组间性别、年龄、高血压、糖尿病、心脏病(房颤)、颈动脉粥样硬化情况及生化指标(白细胞、白蛋白、超敏C反应蛋白、尿酸、半胱氨酸蛋白酶抑制剂C、甘油三脂、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B、同型半胱氨酸)上是否存在差异。结果:294例入组患者,男182例,女112例,平均年龄63.59±10.53岁。合并甲状腺功能异常62例,占21.09%。亚临床甲亢和亚临床甲减患者共56例,占异常组的90.32%。甲亢组房颤发生比例高于正常组,两组间存在统计学差异(P0.05)。甲减组颈动脉狭窄发生比例高于正常组(P0.017)。甲减组半胱氨酸蛋白酶抑制剂C平均水平高于甲亢组,差异有统计学意义(P0.05)。结论:甲状腺功能异常与脑梗死关系密切,其原因考虑与甲功异常与多种脑血管病危险因素(房颤、颈动脉狭窄、半胱氨酸蛋白酶抑制剂C)相关,提示甲状腺功能异常可能是脑梗死的独立危险因素。
[Abstract]:Objective: to observe the incidence of thyroid dysfunction in patients with acute cerebral infarction and its influence on risk factors of cerebral infarction, and to explore the possible role of thyroid dysfunction in the occurrence and development of acute cerebral infarction. Methods: new cerebral infarction cases were collected from July 2015 to June 2016 in Department of Neurology, second Hospital of Jilin University. The patient was examined with previous history, history of tobacco and alcohol, blood test and color Doppler ultrasound of neck blood vessel. According to thyroid function 294 patients with new cerebral infarction were divided into hyperthyroidism group (including clinical hyperthyroidism and subclinical hyperthyroidism) hypothyroidism group (including clinical hypothyroidism and subclinical hypothyroidism) and normal thyroid function group. Sex, age, hypertension, diabetes, heart disease (AF), carotid atherosclerosis and biochemical parameters (leukocyte, albumin, hypersensitive C-reactive protein, uric acid) were analyzed and compared. Whether there is any difference in C, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A, apolipoprotein B, homocysteine. Results there were 294 cases (182 males and 112 females) with an average age of 63.59 卤10.53 years. There were 62 cases (21.09%) with abnormal thyroid function. There were 56 cases of subclinical hyperthyroidism and subclinical hypothyroidism, accounting for 90.32% of abnormal group. The incidence of atrial fibrillation in hyperthyroidism group was higher than that in normal group, and there was statistical difference between the two groups (P0.05). The incidence of carotid artery stenosis in hypothyroidism group was higher than that in normal group (P0.017). The average level of cysteine protease inhibitor C in hypothyroidism group was higher than that in hyperthyroidism group (P0.05). Conclusion: thyroid dysfunction is closely related to cerebral infarction, and its causes may be associated with thyroid dysfunction and various risk factors of cerebrovascular disease (atrial fibrillation, carotid artery stenosis, cysteine protease inhibitor C). The results suggest that abnormal thyroid function may be an independent risk factor for cerebral infarction.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.33;R581

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