脓毒症患者甲状腺激素、皮质醇水平变化与预后的关系

Relationship between serum levels of thyroid hormones,cortisol and prognosis in sepsis patients

目的探讨血清甲状腺激素、皮质醇水平变化对脓毒症患者预后的影响。方法对54例脓毒症患者、30例非脓毒症患者血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)含量及血清皮质醇(COR)浓度进行对照分析,并对脓毒症生存和死亡患者的甲状腺激素水平和COR水平与APACHEⅡ评分的相关性进行分析。结果与非脓毒症组比较,脓毒症患者COR水平明显增高,而甲状腺激素水平明显降低。脓毒症生存组COR水平明显高于死亡组,而甲状腺激素水平明显降低。脓毒症患者APACHEⅡ评分与血清COR水平呈显著正相关,而与FT3、FT4呈显著负相关(均P<0.05)。结论血清甲状腺激素、COR水平在一定程度上可反映脓毒症疾病的严重程度,可作为评价脓毒症患者预后的预测指标。

Objective To explore the relationship between serum levels of thyroid hormones,cortisol and prognosis in sepsis patients. Methods 54 sepsis patients and 30 non-sepsis patients were collected.The acute physiology and chronic health evaluation II （APACHE II ）score,free T3 （ FT3 ） , free T4 （ FT4 ） ,thyroid stimulating hormone（TSH）and cortisol（COR）were detected with cross-check analysis.The APACHE II score, serum levels of thyroid hormones and COR in sepsis patients were detected with correlation analysis. Results Contrast with non-sepsis patients,in sepsis patients the levels of COR were obviously higher, the levels of thyroid hormones were obviously lower. In the survival group, the levels of COR were obviously higher than the fatality group,but the levels of thyroid hormones were obviously lower.There was obviously positive correlation between APACHE II score and COR, but negative correlation between FT3 , FT4 and APACHE II score（all P 〈 0.05）. Conclusion The levels of thyroid hormones and COR can reflect the severity of sepsis, and can be refered to evaluating the prognosis of sepsis patients.