脓毒症患者甲状腺激素水平和血清氨基末端脑钠肽前体变化及其相关性

Changes of levels of thyroxin and N-terminal pro-brain natriuretic peptide and its correlation in patients with sepsis

目的:观察脓毒症患者甲状腺激素水平与氨基末端脑钠肽前体(NT-proBNP)的变化及其对预后的影响。方法:86例脓毒症患者,根据病情分为脓毒症组(52例)和重度脓毒症组(34例),测定血清促甲状腺素(TSH)、游离甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及NT-proBNP水平,随访28 d,比较2组各指标差异。结果:重度脓毒症组血清FT3明显低于脓毒症组(P<0.05),而NT-proBNP水平明显高于脓毒症组(P<0.05);TSH、FT4水平无明显差异。死亡组患者血清FT3水平低于存活组(P<0.05),NT-proBNP明显高于存活组(P<0.05);且血清FT3水平与NT-proBNP呈显著负相关(r=-0.752,P<0.01),血清FT4、TSH水平与NT-proBNP无明显相关性(r=8.324,P>0.05)。结论:血清FT3、NT-proBNP水平可作为判断脓毒症患者严重程度及预后的参考指标,FT3水平可从侧面反映脓毒症心功能障碍的严重程度。

Objective： To observe the changes of levels of thyroxin and N-terminal pro-brain natriuretic peptide （ NT- proBNP） in patients with sepsis and their effects on prognosis. Methods： Eighty-six patients with sepsis were divided into sepsis group （52 cases） and severe sepsis group （34 cases） according to the disease condition. Serum levels of TSH,FT3 ,FF4 and NT-proBNP were measured, and patients were followed up for 28 days and the above indexes were compared between each group. Results ： Serum level of FT3 was significantly lower in the severe sepsis group than that in sepsis group （ P 〈 0.05 ） , while the level of NT-proBNP was significantly higher than that in sepsis group （ P 〈 O. 05 ） , there were no changes in TSH and FT4. The serum level of FT3 was lower in death group than that in survival group （P 〈 0. 05 ） , while the level of NT-proBNP was higher in death group than that in survival group （ P 〈 0.05 ）. Serum level of FT3 was negatively correlated with NT-proBNP （r = -0. 752,P 〈 O. 01 ）. There were no significant correlation between levels of FT4,TSH and NT-proBNP （ r = 8. 324, P 〉 0.05 ）. Conclusions ： Serum levels of FT3 and NT-proBNP may be regarded as reference indexes to judge the severity and prognosis of sepsis, FT3 can reflect the severity of cardiac dysfunction.