Clinical Significance Of Sick Thyroid Syndrome For Infection After Stroke

purposeTo explore the clinical significance of thyroid sick syndrome(ESS)on post-stroke infection and the clinical significance of ESS on post-stroke infection in patients with cerebral infarction of different TOAST types.methodA total of 1005 patients diagnosed as ACI(Acute Cerebral Infarction)by CT/MRI in the Department of Neurology at the Headquarters of Suzhou Hospital(Suzhou Municipal Hospital)of Nanjing Medical University from December 2012 to February 2019 were collected and tested for thyroid function indicators And divided into 218 cases in the low T3 group(ESS group)and 787 cases in the normal T3 level group(control group)according to their T3 levels.Determine the PSI group and non-PSI group according to the clinical symptoms,laboratory examinations and device examinations,and collect relevant clinical data and NIHSS scores of patients.Within 72 hours of admission,perform head MRI,MRA,CTA or DSA and carotid color Doppler ultrasound examination and clinical The data determined the TOAST classification of the patients,compared the related risk factors and the severity of the neurological deficits of the patients,conducted statistical analysis,and reached corresponding conclusions.result1.The age,atrial fibrillation,LDL-C(low-density lipoprotein),NIHSS score at admission,and the drinking water test(?2 grade)in the ESS group were significantly higher than those in the control group(both P<0.05).The levels of T3,fT3,fT4 and TSH in the ESS group were significantly lower than those in the control group(all P<0.05).There was no significant difference in T4(all P>0.05).2.The proportion of patients in the infected group with age,hypertension,atrial fibrillation,LDL-C,NIHSS score at admission,accompanied by ESS and drinking water experiments(?2 grade)was significantly higher than that of the control group(all P<0.05).The fT3 and fT4 levels in the infected group were significantly lower than those in the control group(all P<0.05).But T3,T4,TSH had no significant difference(all P>0.05).3.Logistic regression analysis showed that advanced age,atrial fibrillation,NIHSS score at admission and ESS were independent risk factors for patients with acute cerebral infarction associated infection(all P<0.05).4.In the comparison of TOAST subtype distribution between ESS group and normal T3 group,the proportion of LAA type in ESS group was significantly lower than that of control group(P<0.01),and the proportion of SAO type in ESS group was significantly higher than that of control group(P<0.01).In the comparison of TOAST subtype distribution between two groups of infected patients,the proportion of LAA type in ESS group was significantly higher than that of control group(P<0.01),and the proportion of SAO type in ESS group was significantly lower than that of control group(P<0.01).5.Compared with the clinical data of the non-infected group and the infected group in LAA patients,the patient's age,atrial fibrillation,creatinine,NIHSS score at admission,accompanied by ESS and high drinking water test score(?2 grade)are significantly positively correlated with infection risk(P<0.05),LDL-C was significantly negatively correlated with infection risk(P=0.027).Comparing the clinical data of non-infected group and infected group in SAO patients,high blood pressure,NIHSS score and Watian drinking water test score(?2 grade)were positively correlated with infection risk(P<0.05).6.LAA type multivariate logistic regression analysis showed that atrial fibrillation,NIHSS score on admission,high water drinking test score(?2 grade)and ESS were independent risk factors for infection associated with LAA acute cerebral infarction(P<0.05).7.Multivariate logistic regression analysis showed that hypertension and high drinking water test scores(? 2 grades)were positively correlated with the occurrence of infection in patients with SAO-type acute cerebral infarction(P<0.05),while LDL-C was associated with SAO-type acute cerebral infarction There was a negative correlation(P = 0.045)between the occurrence of patients with infection.The study found that hypertension,LDL-C and high drinking water test scores(? 2 grades)are important influencing factors for infections associated with SAO-type acute cerebral infarction.conclusion1.Old age,atrial fibrillation,NIHSS score on admission and ESS are the independent risk factors for patients with acute cerebral infarction.2.ESS can predict the occurrence of post-stroke infection in patients with cerebral atherosclerosis and arterial occlusion.3.ESS,atrial fibrillation,severe neurological deficits and Watian drinking water test(?2 grade)are independent risk factors for post-stroke infection in patients with aortic atherosclerotic cerebral infarction.4.High blood pressure,LDL-C and high drinking water test scores(? 2 grades)are independent risk factors for concomitant infection in patients with small arterial occlusive cerebral infarction.