不同程度脑外伤后甲状腺激素水平的临床观察

CLINICAL OBSERVATION OF SERUM THYROID HORMONE LEVELS IN PATIENTS WITH DIFFERE-NT DEGREE OF HEAD INJURY

按脑外伤后10小时GCS评分,随机选择轻、中、重度脑外伤病例各30例,分别测其入院时、第一周内各天及第14天早晨甲状腺激素水平,发现甲状腺激素水平与病情及其变化明显相关:1.T_3下降最快,最明显,且病情越重下降越显著;2.T_4持续下降低于正常值提示预后不良;3.rT_3随病情加重而升高,但恢复较快;4.FT_3,FT_4变化基本与T_3、T_4相同,但不如其显著;5.TSH早期可升高,危重组低于正常值。

Head injury patients were classified into three groups:minor, moderate and severe according to the Glascow coma score(GCS)and 30 cases were chosen at random in each group. Thyroid hormone levels were determined daily in the fivst week and at the 14 th day.The following results were observed. 1. Lowering of T3 levels was most rapid and marked and positively correlated with severity of injury; rT3 changes were in the opposite direction but recovered more quickly. 2. persistent lowering of T4 suggested poor prognosis. 3. Changes in FT3 and FT3 were similar to those of T3 and T4 but less marked. 4. TSH could be increased in early stage bat became lower than normal in critical cases.