急性颅脑损伤患者甲状腺激素变化的临床干预研究

Clinical intervention of thyroid hormone changes in patients with acute craniocerebral injury.

目的探讨急性颅脑损伤患者甲状腺激素变化的临床干预方法和效果。方法选择我院2011年5月至2013年5月经过确诊的153例急性颅脑损伤患者。将存在甲状腺素水平下降变化的88例患者进行格拉斯哥GCS评分,分型后确定三类患者,分别按每类患者情况随机分为治疗组(43例)和对照组(45例)。治疗组给予甲状腺素片替代治疗,对照组则采取常规方式进行相应治疗。比较经不同方式治疗后,患者于伤后不同时间的T3和FT3水平以及患者死亡率、致残率以及GOS评分情况。结果以整体水平而言,治疗组和对照组T3和FT3呈现上升恢复趋势。治疗组恢复水平要明显高于对照组,且T3和FT3于7 d和14 d含量水平显著高于对照组,差异均具有统计学意义(P<0.05)。治疗组在死亡率和致残率方面显著低于对照组,在GOS评分方面显著高于对照组,差异均具有统计学意义(P<0.05)。结论对于因急性颅脑损伤而致甲状腺素水平发生下降的患者,给予甲状腺素片治疗是一种可行、有效的治疗方法,且实施条件要求不高,一般县级医院均可进行。因此,该疗法具有较好的市场应用前景,值得临床推广应用。

Objective To investigate the clinical intervention method of thyroid hormone changes in patients with acute craniocerebral injury （ACI） and the effect.Methods A total of 153 patients were confirmed as ACI in our hospital from May 2011 to May 2013,of which 88 with decreased thyroid hormone levels were classified into three types based on Glasgow GCS score.The 88 patients were randomly assigned into the treatment group （n=43） and the control group （n=45）.The treatment group was given thyroxine tablets for replacement therapy,the control group was treated with the conventional therapy.The T3 and FT3 levels,mortality,disability rate,and GOS score at different time points were compared between the groups.Results To the overall level,the T3 and FT3 levels in the treatment group and the control group showed an upward trend.But the treatment group＇s level was significantly higher than the control group＇s.And T3 and FT3 levels 7 d and 14 d after treatment in the treatment group were significantly higher than those in the control group （P〈0.05）.The treatment group＇ s mortality and disability rate were significantly lower than the control group＇s,but GOS score was significantly higher （P〈0.05）.Conclusion For patients with decreased thyroid hormone levels caused by ACI,the application of thyroxine tablets for treatment is viable and effective,which is easy to operate and can be implemented in general county hospitals.This treatment has good market prospect and is worthy of recommendation.