Abstract: Objective · To explore the association between thyroid-related hormones and antibodies and the prognosis of ischemic stroke patients treated with intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA). Methods · A total of 213 consecutive patients with ischemic stroke who underwent rt-PA intravenous thrombolysis in the Department of Neurology, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, were retrospectively included May 2012 to August 2018. Thyroid-related hormones and antibodies were tested on admission, and assessment of intracranial hemorrhage (ICH) was conducted 24 hours after thrombolysis. Functional outcomes were assessedmodified Rankin Scale (mRS) after 3 months of follow-up. The relationship between thyroid-related hormones and antibodies and the prognosis (including functional outcome and ICH) was analyzedlogistic regression analysis. Results · In univariate regression analysis, free triiodothyronine (fT3), total triiodothyronine, (tT3) and total thyroxine (tT4) levels were associated with poor functional prognosis (P0.000, P0.028, P0.000) and fT3, and free thyroxine (fT4) levels were associated with ICH (P0.008, P0.014). However, after adjustment for other variables, low fT3 levels were independently associated with poor prognosis (OR0.35, 95%CI 0.138-0.890, P0.027), and both fT3 and fT4 levels had nothing to do with ICH. In addition, fT3 was negatively correlated with stroke severity (r-0.291, P0.000). Conclusion · Low fT3 levels are associated with stroke severity and functional outcome.

Key words: ischemic stroke, intravenous thrombolysis, thyroid-related hormones, functional outcome, intracranial hemorrhage