侧支循环开放不佳是大动脉粥样硬化型脑梗死患者伴发低T3综合征预后差的重要影响因素

摘要

目的 分析大动脉粥样硬化型脑梗死患者伴发低T3综合征的影响因素及预后情况.方法 收集本院及苏州市立医院2012年1月至2014年12月间的脑梗死患者的临床资料,利用MRA、CTA或DSA分析其TOAST分型并评价侧支循环开放情况,随访1年预后(mRS评分),分析低T3综合征发生的影响因素及预后情况.结果 显示与正常T3组患者相比,低T3综合征组患者T3水平显著降低(P=0.001),TSH水平明显升高(P<0.001).低T3综合征组患者预后差(P=0.008),死亡率较高(P=0.002).通过Logistic回归分析发现侧支循环开放比例较低(P<0.05)及高龄(P<0.001)是发生低T3综合征的重要影响因素.结论 低T3综合征预示大动脉粥样硬化型脑梗死患者预后差,高龄及侧支循环开放比例较低可能是其重要原因.%Objective To explore the influencing factors underlying the poor prognosis in cerebral infarction patients with low T3 syndrome.Methods Data were collected from patients in our hospital and Suzhou Municipal Hospital between January 2012 and December 2014. Status of collateral circulation and TOAST subtype was assessed by MRA、CTA or DSA. Essential clinical data were analyzed for influencing factors and mRS score followed one year after stroke for the prognosis.Results Compared with patients in normal T3 group, significantly lowered T3 levels (P=0.001) and elevated TSH levels(P<0.001) were found in low T3 group. Poor prognosis(P=0.008) was found in low T3 group mainly because of heightened mortality(P=0.002). Lower opening rate of collateral circulation(P<0.05) and advanced age(P<0.001) were found as the critical impact on incidence of low T3 syndrome.Conclusion Low T3 syndrome predicted poor prognosis in cerebral infarction patients of large artery atherosclerosis. Lower opening rate of collateral circulation and advanced age were two significant contributors.