Correlation Between Serum Thyroid Correlative Hormones And Post-stroke Depression In Patients With Acute Cerebral Infarction

Objective:To analyze the changes of serum thyroid correlative hormones in the acute phase of ischemic cerebrovascular disease,and to explore the correlation between serum free triiodothyronine（free triiodothyronine,FT3）,thyrotropin（thyroid-stimulating hormone,TSH）,and free thyroxine（free thyroxine,FT4）and Post-stroke depression.Methods:1.A total of 100 patients with acute cerebral infarction admitted to our hospital from October 2019 to November 2020 were collected as the study subjects.The next day,patients with a score of more than 4 on Health Questionnaires-9 were given a Hamilton Depression Scale-17（HDRS-17）.All patients with acute cerebral infarction were divided into the PSD group and the Non-PSD group.HDRS-17 scale was used to retest the score at 14 days.The changes of FT3,FT4,and TSH in fasting serum of all patients were collected on 2d and 14d.At the same time,we collected 80healthy people in our hospital as a healthy control group,collecting blood once.The general information of the patients with acute cerebral infarction shall be recorded,including sex,age,education level,number of recent adverse life events,etc;whether the patients have been complicated with hypertension,diabetes,and other medical histories;and whether the patients have been admitted to the hospital for routine testing of liver and kidney functions and blood lipids.2.The differences of FT3,FT4,and TSH levels in the PSD group,Non-PSD group,and healthy control group on the 2nd day were analyzed.The thyroid hormone levels in the PSD group and Non-PSD group were observed on the 2nd and 14th day.At the same time,according to the HDRS-17 scale standard:7-16 for mild depression,17-23 for moderate depression,more than 24 for severe depression,discuss the relationship between serum FT3 changes and the severity of depression.Pearson method was used to analyze the correlation between thyroid corticosteroids and Hamilton Depression Scale.Result:1.Differences in thyroid hormone levels in the three groups on day 2:Serum FT3 decreased（P<0.001）,FT4 increased（P<0.001）and TSH decreased（P<0.001）in patients with acute cerebral infarction（PSD and non-PSD）compared with healthy controls.2.On the second day,serum FT3 and TSH levels in the PSD group were lower than those in the Non-PSD group（P<0.001）,serum FT4 levels were higher than those in the Non-PSD group（P<0.001）and non-PSD group（P<0.001）.On the 14th day,serum FT3,FT4,and TSH levels were the same as those on the 2nd day.The levels of serum FT3,FT4,and TSH in the PSD group and Non-PSD group decreased in the 2nd and 14th day,except that the changes of FT4 in the PSD group had no significant difference,the changes of other variables were significant.3.Relationship between serum FT3 level and depressive disorder degree:The level of serum FT3 in 2 days after stroke was ladder-like,the lowest level of severe depression was（0.99±0.06）pg·ml^-1,moderate depression（1.11±0.02）pg·ml^-1,mild depression（1.27±0.09）pg·ml^-1,and the difference was statistically significant.Outcome 14 days after stroke:Similar ladder was seen the following day.4.Correlation analysis of Hamilton Depression Scale score and serum FT3,TSH,and FT4:Hamilton Depression Scale score was negatively correlated with FT3,positively correlated with FT4,negatively correlated with TSH,all had statistical significance.Conclusion:1.PSD was higher after acute cerebral infarction.2.Thyroid hormone changes in patients with acute cerebral infarction:compared with healthy people,FT3 level decreased,FT4 level increased,TSH level decreased,and the hormone changes in patients with PSD were more obvious.3.The changes of serum FT3,FT4 and TSH in patients with acute cerebral infarction are correlated with post-stroke depression.The observation of the changes of these indexes can provide reference for the identification of early PSD in patients with acute cerebral infarction.