危重病患者血清降钙素原和甲状腺激素测定的意义

Significance of serum procalcitonin and thyroid hormone in critically ill patients

目的研究危重病患者血清降钙素原(PCT)和甲状腺激素(TH)含量测定的意义。方法应用免疫透射比浊法与化学免疫发光法测定50例正常对照组和80例重症监护病房(ICU)患者入科和出科时的PCT与T3、T4、TSH的含量,同时采集血液进行细菌培养,部分病例采集痰、尿、创面分泌物、粪便等标本作细菌培养。结果危重病组血清PCT水平明显高于对照组,其细菌培养阳性组PCT水平明显高于阴性组,死亡组PCT水平明显高于存活组(P<0.01),差异有统计学意义;而危重病组血清T3、T4含量低于对照组,细菌培养阳性组T3、T4含量低于阴性组,死亡组T3、T4含量低于存活组(P<0.01或P<0.05),差异有统计学意义;各组的TSH含量变化则无统计学意义(P>0.05)。结论监测血清PCT、T3、T4水平可作为了解病情、判断预后的客观指标。

Objective To study the significance of serum procalcitonin （PCT） and thyroid hormone （TH） in critically ill patients. Methods Fifty normal subjects as control group and 80 patients in intensive care unit （ICU） were examined for PC-T, T3, T4, and TSH levels at the time of admission to and leaving the medical ward, and blood bacterial cultures of all patients, were performed while in some patients microbe cultures of sputum, urine, secretions of surgical wounds, or feces were carried out and analyzed by immunoturbidimetric assay and chemiluminescence immunoassay. Results Serum PCT level in critically ill patients was significantly higher than that in control group, that in bacterial culture positive group was much higher than that in negative group.and that in surviving group was higher than that in dead group （ P 〈 0.01 ）. Serum levels of T3 and T4 were significandy higher in critically ill patients than those in control group, those in bacterial culture positive group were lower than those in negative group, and those in surviving group were higher than those in dead group （ P 〈 0.01 / P 〈 0.05） ; but TSH index was not significantly different among all groups（P〉 0.05） .Conduslom Mornitoring the levels of serum PCT,T3 and T4 can offer objective indexes to the severity and prognosis in critically ill patients.