The Clinical Significance Of Low T3 Syndrome In Cerebral Infarction Patients With Large Artery Atherosclerosis

Objective : To explore the mechanism underlying the poor prognosis in cerebralinfarction(c I)patients with low T3 syndrome by comparing the NIHSS scores in these patients with or without low T3 syndrome.Methods:Four humdred and fifty eight patients with CI,admitted to Suzhou municipal hospital from January 2010 to December 2015,were chosen in our study;the levels of thyroid hormones,including triiodothyronine(T3),four iodine thyronine(T4),thyroid stimulating hormone(TSH),free Triiodothyronine(f T3)and free four iodine thyronine(t T4),were measured by radioimmunoassay.CI lesions and TOAST distribution were determined by cranial MRI,magnetic resonance angiography(MRA)or CT angiography(CTA),and carotid ultrasonography.NIHSS scores at the worst in cerebral infarction inpatients were detected.Results : Small arteries in anterior circulation occlusion patients with LT3 S distribution LT3 S distribution rate below the rate(P=0.049),and anterior circulation in patients with cardiogenic embolism were significantly higher than those not associated with LT3 S distribution rate(p=0.004).Low T3 syndrome with large artery atherosclerosis in patients with cerebral infarction of internal carotid artery system peak NIHSS score was significantly higher than normal T3(p = 0.003).Conclusion : The neurologic impairment is more severe in large artery atherosclerosis—internal carotid artery patients with low T3 level than those without low T3 level,which might be responsible for the poor prognosis of the illness with low T3 syndrome.Objective: To explore the influencing factors underlying the poor prognosis in cerebral infarction patients with low T3 syndrome.More severe neurological deficits were only found in patients with large artery atherosclerosis of internal carotid artery system concomitant with low T3 syndrome from our prior study.Influencing factors and prognosis were analyzed for service of treatment and prognosis prediction in this study for comorbidity with low T3 syndrome among patients of large artery atherosclerosis.Methods: Data were collected from patients at Affiliated Suzhou Hospital of Nanjing Medical University and our hospital between 2012 and 2014.Status of collateral circulation and TOAST subtype was assessed by MRA?CTA or DSA.Essential clinical data were analyzed for influencing factors and m RS 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.