【摘要】 目的 探讨亚临床甲状腺功能异常对急性脑梗死严重程度的影响。方法 选取2018年1月～2019年12月清华大学第一附属医院471例急性脑梗死患者。根据促甲状腺激素(thyoroid-stimulating hormone, TSH)水平分为甲状腺功能正常组398例(84.5%),亚临床甲状腺功能减低组41例(8.7%),和亚临床甲状腺功能亢进组32例(6.8%)。所有患者均评估脑血管疾病的危险因素、颈动脉狭窄程度，在入院和出院时用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale, NIHSS)进行评分。比较不同甲状腺功能的急性脑梗死患者血管危险因素、颈动脉狭窄患病率和NIHSS评分的差异。结果 脑血管疾病血管危险因素在亚临床甲状腺功能异常和甲状腺功能正常组间无统计学差异(P>0.05)。亚临床甲状腺功能减低组的急性脑梗死患者颈动脉狭窄患病率更高(P<0.05),亚临床甲状腺功能亢进组的急性脑梗死者入院时NIHSS评分更高(P<0.05)。结论 亚临床甲状腺功能减低显著加重颈动脉狭窄，但对脑梗死急性期的神经功能影响不大；亚临床甲状腺功能亢进可加重脑梗死急性期的病情，恶化神经功能。更多还原

【Abstract】 Objective To evaluate the effects of subclinical thyroid disorders on severity of acute cerebral infarction. Methods A total of 471 patients with acute cerebral infarction were recruited from January 2018 to December 2019 at the First Affiliated Hospital of Tsinghua University. Patients were divided into euthyroidism group(n=398, 84.5%), subclinical hyperthyroidism group(n=32, 6.8%) and subclinical hypothyroidism group(n=41, 8.7%) based on the level of thyoroid-stimulating hormone(TSH). The demographic profiles, arteriosclerotic risk factors, the prevalence of internal carotid artery stenosis and the National Institutes of Health Stroke Scale(NIHSS) scores at admission and discharge were evaluated and compared in the different thyroid function groups. Results The arteriosclerotic risk factors were not significantly different between the group of subclinical thyroid disorder and the group of normal thyroid function(P>0.05). However, the percentage of patients with internal carotid artery stenosis in the subclinical hypothyroidism group was higher than that in other 2 groups(P<0.05). The NIHSS scores at admission in subclinical hyperthyroidism were higher than those in euthyroidism(P<0.05). Conclusion The subclinical hypothyroidism could significantly worsen the internal carotid artery stenosis in acute cerebral infarction, which could not aggravate the neurological function. The subclinical hyperthyroidism could aggravate the neurological severity in the stage of acute cerebral infarction.更多还原