血清甲状腺激素变化与危重病预后的关系初探

Preliminary search on the relationship between the changes of Plasma thyroid hormone and prognosis of critical disease

目的探讨SICU危重病人血清甲状腺激素(TH)的变化与预后的关系。方法应用放射免疫法测定56例无甲状腺疾病病史的危重病人入SICU后第一、三、五天血清TH含量。结果第一天T3/FT3含量(T3:0.21±0.27nmol/L,FT3:1.32±0.67pmol/L)明显低于正常参考值(T3:1.40～3.40nmol/L,FT3:2.50～9.82pmol/L),P<0.01。之后存活病人T3/FT3顺时性上升,到第五天仍低于正常参考值;死亡病人T3/FT3则进行性下降,T4/FT4也明显降低,与存活病人比较有显著性差异(P<0.01)。结论ICU危重病人血清TH下降程度反映了病情危重程度,可作为评估预后的一项参考指标。

Objective To investigate the clinical significance of changes in plasma thyroid hormone(TH) in critical patients of surgery. Mothods Plasma thyroid hormone concentrations were measured in 56 patients of major surgery in first,third and fifth day by radioimmunoassay.Results Plasma T3 and FT3 concentrations in patients after surgery in first day were markedly lower than that normal parameter( P < 0.01).In the later on,T3,FT3 of survivol patients were orthodromic increase,but they were still lower than that noromal parameter until to fifth day.T3,FT3 of dead patients were reduced progresively and T4,FT4 also were reduced apparently.Comparing with the survival patients,there were remarkable difference( P < 0.01).Conclusion The reduced level of TH can reflect the degree of critical disease for SICU of surgical patients.It can serve evaluated prognosis as a reference index.