| BackgroundAcute subarachnoid hemorrhage(SAH)is a very serious disease that affects not only the function of the brain,but also the function of multiple other organ systems.It is estimated that 2-22 cases of acute SAH occur per 100,000 people per year,of which 60% of acute SAH occur in people aged 40-60.Although the mortality rate from acute SAH has steadily declined in recent years,from greater than 50% to about 35% percent,the disease is still associated with considerable morbidity and mortality.The most common cause of acute SAH is aneurysm subarachnoid hemorrhage(aSAH)caused by ruptured intracranial aneurysms.Intracranial aneurysms are cerebrovascular accidents,which refer to abnormal protrusion on the wall of the intracranial artery tube.At present,for patients with aSAH,the evaluation of prognosis is usually the use of traditional clinical prognosis model.However,the value of using traditional clinical prognostic model in evaluating prognosis is still insufficient,so we still need to improve the risk stratification of aSAH patients.The relevant evidence suggests that serum T3 concentrations can be used as important biomarkers for the evaluation of prognosis in patients with acute cerebrovascular disease,including aSAH,cerebral hemorrhage and ischemic diseases.The lower than normal plasma T3 concentration was related to the higher severity of the disease in patients with aSAH,poor health,complicated clinical course and poor prognosis of discharge.The decrease in plasma T3 concentrations was also associated with higher long-term mortality rates and increased disability rates in patients with aSAH.After aSAH,low T3 syndrome appeared in up to one-third of patients,but the correlation between plasma T3 concentration and aSAH prognosis was unclear.Objective1.To observe the changes in the concentration of thyroid hormones in aSAH disease environment;2.To study the relationship between plasma tri-iodine hypothyroidism(FT3)concentration and the severity and prognosis of the disease in patients with identified aSAH disease.Materials and MethodsWe collected a total of 80 patients who were admitted to the Department of Neurology,the first affiliated Hospital of Zhengzhou University between May 2017 and May 2018 for hospitalization,and they all met the inclusion criteria of this study;At the same time,the control group collected 100 patients who underwent a health examination in our hospital at the same time,and the sex and age were matched.Intravenous blood collection was carried out,and plasma was used for the determination of thyroid function,including free tri-iodine thyroid methionine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH).aSAH patients were taken to take intravenous blood as a sample before treatment in the aSAH group before receiving any treatment after admission to hospital;after surgery,internal medicine and other treatment,the patient was discharged from hospital with fasting vein blood as a sample after treatment,control group patients extracted fasting vein blood as a control group sample.ResultsCompared with the health examination group,the plasma FT3 concentration decreased significantly in the patients in the aSAH group before treatment,and the comparison between the two groups was statistically significant(P < 0.05).In aSAH group,the plasma FT3 concentration increased significantly after treatment compared with before treatment,and the mean of the two groups was statistically significant(P< 0.05).Compared with the health examination group,the plasma FT3 concentration was lower after treatmentin in aSAH group patients,and the comparison between the two groups was statistically significant(P < 0.05).There was no significant difference in the mean comparison of plasma FT4 and TSH concentrations in each group,and no statistically significant(P >0.05).According to Hunt & Hess grading,the incidence of NTIs in aSAH group in the poor group was significantly higher than that in the good group,that is,the difference was statistically significant(P<0.05).There was a significant increase in mortality in aSAH patients with NTIs group than wuthout NTIs group,that is,the difference was statistically significant(P<0.05).ConclusionsThe concentration of thyroid hormones in circulating plasma should be monitored in clinical work,which may be beneficial to clinicians in judging the severity of the disease,as well as the benefits of clinicians in evaluating the prognosis of aSAH patients. |
