感染性休克早期血清甲状腺功能的变化和意义

Changes and significance of thyroid function at the early stage of sepsis shock

目的探讨感染性休克早期血清甲状腺功能的变化和意义。方法选择15例感染性休克患者（休克组）和20例严重全身感染患者（感染组）在确诊后第1、3、5天应用电化学发光法测定血清三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离T3（FT3）、游离T4（FT4）、促甲状腺激素（TSH）；同期选择20例健康体检者（对照组）进行对照分析。结果感染组和休克组T1、T4明显降低（P〈0．05或P〈0．01），以APACHEII评分为标准，T1、T4的变化与严重感染患者病情危重程度密切相关（P〈0．05或P〈0．01）。结论感染性休克早期就伴有不同程度的甲状腺功能减退，并与感染危重程度密切相关。

Objective To explore the changes of thyroid （T3 ） at the early stage of septic shock. Methods There were three groups in our study：①15 patients with septic shock;②20 patients with whole body infection; ③20 healthy volunteers as the control. The concentration of serum three iodine thyroid gland original ammonia acid （ T3 ）, thyroxine （ T4 ） , free triiodothyronine （ FT3 ）, free thyroxine（ FT4） and thyroid stimulating hormone （TSH） were detected in all the subjects by ICMA at 1, 3, 5 d after diagnosis. Results The level of T3 and T4 decreased significantly in the infection group and shock group compared with the control group（P 〈 0.05 or P 〈 0.01 ）. According to APACHE II as the criteria, there was positive relationship between the concentration of serum T3 , T4 and the severity of illness in patients with infection （ P 〈 0.05 or P 〈 0.01 ）. Conclusion At the early stage of septic shock, the infection group and shock group have varying degrees of hypothyroidism, which is closely related to the severity of infection.