Objective Accumulating evidence has suggested that thyroid hormone levels affect the prognosis of acute ischemic stroke (AIS), but the results have been inconsistent. Methods Basic data, neural scale scores, thyroid hormone levels, and other laboratory examination data of AIS patients were collected. The patients were divided into excellent and poor prognosis group at discharge and 90 days after discharge. Logistic regression models were applied to evaluate the relationship between thyroid hormone levels and prognosis. A subgroup analysis was performed based on stroke severity. Results A number of 441 AIS patients were included in this study. Those in the poor prognosis group were older, with higher blood sugar levels, higher free thyroxine (FT4) levels, and severe stroke (all p < 0.05) at baseline. Free thyroxine (FT4) showed a predictive value (all p < 0.05) for prognosis in the model adjusted for age, gender, systolic pressure, and glucose level. However, after adjustment for types and severity of stroke, FT4 showed insignificant associations. In the severe subgroup at discharge, the change in FT4 was statistically significant (p = 0.015), odds ratio (95% confidence interval) = 1.394 (1.068-1.820) but not in the other subgroups. Conclusions High-normal FT4 serum levels in patients with severe stroke receiving conservative medical treatment at admission may indicate a worse short-term prognosis.

中文翻译：

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急性缺血性中风甲状腺激素水平矛盾。

目的越来越多的证据表明甲状腺激素水平影响急性缺血性卒中（AIS）的预后，但结果不一致。方法收集AIS患者的基本资料、神经量表评分、甲状腺激素水平等实验室检查资料。患者在出院时和出院后90天分为预后优组和差组。应用逻辑回归模型评估甲状腺激素水平与预后之间的关系。根据卒中严重程度进行亚组分析。结果 441 名 AIS 患者被纳入本研究。预后不良组的患者年龄较大，血糖水平较高，游离甲状腺素 (FT4) 水平较高，基线时有严重中风（所有 p < 0.05）。在根据年龄、性别、收缩压和葡萄糖水平调整的模型中，游离甲状腺素 (FT4) 显示出预后预测值（所有 p < 0.05）。然而，在针对中风的类型和严重程度进行调整后，FT4 显示出不显着的关联。在出院时的严重亚组中，FT4 的变化具有统计学意义 (p = 0.015)，比值比（95% 置信区间）= 1.394 (1.068-1.820)，但在其他亚组中则没有。结论 入院时接受保守药物治疗的重度脑卒中患者血清 FT4 水平正常偏高可能表明短期预后较差。在出院时的严重亚组中，FT4 的变化具有统计学意义 (p = 0.015)，比值比（95% 置信区间）= 1.394 (1.068-1.820)，但在其他亚组中则没有。结论 入院时接受保守药物治疗的重度脑卒中患者血清 FT4 水平正常偏高可能表明短期预后较差。在出院时的严重亚组中，FT4 的变化具有统计学意义 (p = 0.015)，比值比（95% 置信区间）= 1.394 (1.068-1.820)，但在其他亚组中则没有。结论 入院时接受保守药物治疗的重度脑卒中患者血清 FT4 水平正常偏高可能表明短期预后较差。