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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。
OBJECTIVE: To investigate the relationship between serum anti-thyroid peroxidase antibody levels in patients with acute ischemic stroke and the presence or absence of stenosis and short-term prognosis in patients with intracranial aortic artery. Methods: The clinical data of 225 patients with acute ischemic stroke were retrospectively analyzed. According to the results of craniocerebral MRA, cranial CTA and DSA, the patients with acute stroke were divided into two groups: the stenosis group (n = 146) and non-stenosis group Group (n = 79), and the stenosis group was divided into 1-6 groups according to the stenosis, each group representing a grade. Serum anti-thyroid peroxidase antibody, homocysteine, C-reactive protein, uric acid, thyroid function, blood lipids, blood glucose and other biochemical parameters were detected within 24 h of admission. On the day of admission, the American National Institutes of Health Stroke Scale NIHSS) to assess neurological deficit. At discharge or at 14 days after onset, clinical outcomes were assessed using the modified Rankin Scale (mRS). Results: Serum anti-thyroid peroxidase antibody levels in intracranial aortic stenosis group were significantly higher than those in non-stenosis group (P <0.01). Serum anti-thyroid peroxidase antibody (TPO-Ab) [odds ratio (OR) 1.003, 95% confidence interval (CI) (1.001-1.005); P <0.05] Independent risk factors for vascular stenosis in infarcted patients. Serum anti-thyroid peroxidase antibody levels at admission were associated with poor short-term outcomes (P <0.01), but no significant differences were found after adjusting for other confounding factors (OR: 0.998, 95% CI: 0.993-1.002; P> 0.05.Conclusion: Serum anti-thyroid peroxidase antibody level in patients with acute ischemic stroke is an independent risk factor for vascular stenosis in patients with cerebral infarction, but not with the degree of stenosis and short-term prognosis.