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العنوان
Thyroid Function Hormones Profile in Acute Stroke Patients /
المؤلف
Elkhiat, Nehad Elsaied Abdelmaksoud.
هيئة الاعداد
باحث / نهاد السيد عبدالمقصود الخياط
مشرف / هــاله محمود الخــواص
مشرف / شاهيناز محمد حلمي
مشرف / محمد محمد توفيق
تاريخ النشر
2020.
عدد الصفحات
114 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
علم الأعصاب
تاريخ الإجازة
25/2/2021
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم المخ والاعصاب والطب النفسي
الفهرس
Only 14 pages are availabe for public view

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Abstract

C
erebrovascular stroke is the third commonest cause of mortality worldwide and a major cause of long-term disability. Perturbations in the hypothalamus- pituitary-thyroid (HPT) axis affect stroke risk and stroke outcomes. Hypothyroidism can cause hypertension, hypercholesterolemia, cardiac dysfunction, and both hypo- and hypercoagulability, all of which are risk factors for stroke.
AIS severity indicated by NIHSS and the related disabilities had a significant association with low T3 level and thyroidal hormones disturbance compared to euthyroid stroke patients.
This study was conducted on 101 acute ischemic stroke patients who were admitted to the neurology department of Nasser institute hospital. All the patients were evaluated by measuring the thyroid hormone level, NIHSS, and mRS and performing CT, MRI-brain, echocardiography and carotid duplex that will be discussed afterward, in addition to the rest of the stroke protocol that was done routinely to every patient who admitted to the hospital. We also measured the thyroid hormone levels, NIHSS, and mRS after one month of follow up.
The current study included 101 ischemic stroke patients as a random sample, ranged from 18 to 80 years-old with mean age ±SD 63.6 ± 12.4, and showed males percentage of 56.4%. The most prevalent risk factors were HTN in 74 patients (73.3%) and DM in 54 patients (53.5%).
According to our study patients distribution of baseline and 30 days follow up thyroid function and hormones level, the study found (24.75%) of 101 study stroke patients had abnormal thyroid functions, of whome, 17 patients (16.8%) had nonthyroidal illness syndrome (NTIS), 4 patients(3.96%) were with subclinical hyperthyroid, 2 patients(1.98%) were hypothyroidism and (0.99%) of patients in hyperthyroid and subclinical hypothyroid (one patient in each group). About baseline hormones level abnormalities in our patients, Serum TSH level was low in 5 patients (4.95 %), and high in 3 patients (2.97 %). Serum T3 level was low in 18 patients (17.8 %), and high in one patient (0.99%). Serum T4 level was low in 2 patients (1.98 %) and high in 2 patients (1.98 %).
Regarding to study group comparison between normal and abnormal thyroid groups in our study stroke patients related to demographic and base line clinical factors profiles, there was significant difference between the two groups (P < 0.05) in the distribution of sex, HTN and AF.
The comparison between normal and abnormal thyroid groups on our study stroke patients related to other factors profiles as TOAST criteria, ECHO, carotid stenosis and site of infarction didn`t show any significant difference between the two groups (P> 0.05).
We assessed the stroke severity based on NIHSS on day 0 and reported that the majority of patients in abnormal and normal thyroid groups had moderate stroke (80%) and (78.9%) of patients respectively, followed by (7.9%) had minor stroke, (6.9%) had moderate to severe stroke, and (5.9%) had severe stroke in normal group, in contrast in abnormal group as (12%) of patients had severe stroke followed by (4%) of patients in each minor and moderate to severe stroke. although this difference it did`t show any significant value(P > 0.05). there wasn`t significan associations between thyroid hormones and NIHSS on admission (P > 0.05).
We also investigated possible risk factors of the initial and 30th day stroke severity using univariate and multivariate analysis and we found a significant negative correlation between the baseline T3 level and the only 30th day stroke severity in the univariate analysis (P < 0.05).
In the 30th day stroke disabilities in univariate analysis, there was a significant association between baseline T3 level and the mRS scores, a significant negative correlation between baseline T3 level and the mRS score, and a significant association between baseline abnormal thyroid function and unfavorable mRS scores were reported. On the other hand, the multivariate analysis showed that patients with nonthyroidal illness syndrome, dyslipidemia, first stroke, or high baseline NIHSS score had a significant higher mRS score on the 30th day from the stroke onset.