老年患者医院感染与甲状腺功能变化的关系

Relationship between nosocomial infections in elderly patients and change of thyroid function

目的探讨老年患者医院感染与甲状腺功能变化之间的联系,总结临床经验,为甲状腺功能病态综合征(ESS)的预防治疗工作提供理论依据。方法选择医院2012年12月-2013年12月收治的408例患有慢性疾病且无甲状腺疾病的老年患者作为研究对象,调查患者医院感染前后甲状腺功能变化,对患者高敏C-反应蛋白(hsCRP)、甲状腺功能、血清白蛋白和血白细胞等指标进行感染前后的对比,分析其变化趋势,所有数据采用SPSS18.0软件进行分析。结果 408例患有慢性疾病且无甲状腺疾病的老年患者有28例发生医院感染,医院感染率为6.9%;发生医院感染前患者出现ESS的概率为89.3%,发生医院感染后,全部患者均出现ESS,ESS发生率为100.0%;患者发生医院感染后甲状腺功能TT3、TT4、FT3等指标较感染前有明显下降,数据分析比较差异有统计学意义(P<0.05),感染后所有患者均未出现游离T4降低。结论控制医院感染的发生对于老年患者甲状腺功能病态综合征的防治具有较高的临床意义。

OBJECTIVE To explore the correlation between the nosocomial infections in the elderly patients and the change of thyroid function and summarize the clinical experience so as to provide theoretical basis for prevention and treatment of thyroid function sick syndrome .METHODS A total of 408 elderly patients with chronic diseases who did not have the history of thyroid disease and were treated in the hospital from Dec 2012 to Dec 2013 were re‐cruited as the study objects .The change of the thyroid function was observed before and after the patients had the nosocomial infections ;the levels of high‐sensitivity C‐reactive protein （hs‐CRP） ,thyroid function ,serum albu‐min ,and white blood cells were compared before and after the patients had infections ,the change trends were ana‐lyzed ,and the statistical analysis of data was performed with the use of SPSS 18 .0 software .RESULTS The noso‐comial infections occurred in 28 of 408 elderly patients with chronic diseases who did no have the history of thyroid disease ,with the infection rate of 6 .9% .The probability of occurrence of ESS was 89 .3% before the patients had the infections ,while it appeared to 100 .0% after the patients had the infection .The indicators of the thyroid func‐tion including TT3 ,TT4 ,and FT3 were remarkably decreased after the patients had the nosocomial infections , and the analysis of the data showed that the difference was significant （P〈0 .05） ,and none of the patients with infections appeared the decrease of free T 4 .CONCLUSION It is of great clinical significance to control the nosoco‐mial infections so as to prevent the thyroid function sick syndrome in the elderly patients .