危重病患儿垂体-甲状腺轴激素改变的临床评估与分析

Clinical Evaluation and Analysis on Pituitary-Thyroid Axis Hormone Changes of Children with Critically Ill

目的探讨危重病患儿垂体-甲状腺轴激素的改变。方法选择本院监护室危重病患儿75例。其中男42例,女33例;年龄1 d～15岁。根据正性肌力药物评分法分为极危重组、危重组和非危重组。应用化学发光法检测3组患儿血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、血清促甲状腺激素(TSH)水平。应用SPSS12.0软件,采用t检验进行组间分析。结果极危重组17例,其中男11例,女6例;危重组28例,其中男17例,女11例;非危重组30例,男女各15例。与非危重组比较,极危重组、危重组FT3水平均显著降低(P<0.01,0.05);与非危重组比较,极危重组FT4水平明显降低(P<0.05);3组间TSH水平比较差异均无统计学意义(Pa>0.05)。结论患儿处于危重状态时,血清FT3水平低下,而且随病情加重,血清FT3降低更明显。检测FT3可监测临床危重病患儿的内分泌水平的变化。

Objective To explore the changes of the pituitary -thyroid axis hormone in children with critically ill. Methods Seventy - five children with critically ill were divided into severe critical group, critical group and non - critical group aecording to inotopie medicine score. The free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ） and thyroid - stimulating hormone （TSH） were detected. All the data were analyzed by t test. Results The severe critical group had 17 cases（ 11 cases were male,6 cases were female） ,the critical group had 28 cases（ 17 cases were male,ll cases were female） ,non -critic.al group had 30 cases（ 15 cases were male, 15 cases were female）. Compared with non -critical group,the FT3 levels in severe critical group and critical group significantly decreased （P 〈 0.01,0.05）. The difference between non -critical group and severe critical group was significant （P 〈 0.05 ）, but the FT4 levels among 3 groups had no significant difference （P 〉 0.05 ）. Conclusions In critical patients,the FT3 level in blood decreases, with the state of illness aggrapating, the change of FT3 will show more obviously, thus may provide a new provement on the endocrine change monitoring and management on the critical patients.