内科危重病患者血清甲状腺激素水平变化临床观察

Dynamic changes of serum thyroid hormone levels in critically Ⅲ patients

目的:观察内科危重病患者血清甲状腺激素的变化,探讨其临床意义。方法:选择内科危重病患者及体检的健康人群各120例作为研究对象,比较两组人群血清甲状腺激素差异、观察危重病患者死亡与存活者、入院时与好转出院血清甲状腺激素APACHEⅡ的变化。结果:危重病患者血清T3、FT3低于体检的人群(P<0.05),T4、FT4、TSH差异无统计学意义(P>0.05);120例危重病患者死亡18例,存活102例,死亡患者T3、FT3、T4、FT4均低于存活组(P<0.05),而TSH无明显差异(P>0.05);危重病患者好转出院T3、FT3、T4、FT4均高于入院时(P<0.05)。结论:甲状腺激素异常是内科危重病患者的伴随症状,对病情估计,判断预后及疗效有重要的意义。

Objective：To observe the dynamic changes of serum thyroid hormone in critically ill patients, and to explore its clinical significance. Method：The serum thyroid hormone levels of 120 critically ill patients were test- ed and 120 healthy volunteers were selected as control. The levels of serum thyroid hormone and APACHE Ⅱ score were compared between the two groups. Result： The serum levels of T3, FT3 were lower in critical ill patients than in the controls （P〈0. 05）. There were no significant differences of T4, FT4 and TSH between the two groups. （P〉0.05）. There were 18 patients died in the 120 cases of critically ill patients. The serum levels of T3 , FT3, T4, FT4, APACHEⅡ score were lower in patients who were died than the survival patients （P〈0.05）, while TSH has no significant difference （P〉0.05）. The serum levels of T3, FT3, T4, FT4, APACHEⅡ score were higher in convalescent phase than the acute phase （P〈0.05）. Conclusion：The abnormalities of serum thyroid hormone levels could be found in critically ill patients, which could he used to estimate the severity, prognosis and the effects of treatments.