老年患者甲状腺激素水平与感染和心功能不全的关系

Relationship of Levels of Thyroid Hormones with Infection and Cardiac Dysfunction in Hospitalized Elderly Patients

目的：探讨老年住院患者甲状腺激素水平与感染指标和心衰指标水平的关系。方法：选取2016年9月至2017年8月在武汉大学人民医院老年病科就诊的已排除下丘脑、垂体和甲状腺疾病的252例老年住院患者作为研究对象。采集患者基本病例资料及实验室检查指标,包括血浆游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、降钙素原（PCT）与超敏C反应蛋白（hs-CRP）、N末端前体B型利钠肽（NT-proBNP）、乳酸脱氢酶（LDH）和肌酸激酶（CK）。根据患者甲状腺激素水平,分为正常甲状腺激素组（n=126）和低甲状腺激素组（n=126）,并对实验室指标进行统计学分析。结果：低甲状腺激素组患者PCT、hs-CRP、NT-proBNP和LDH水平明显高于正常甲状腺激素组,差异均有统计学意义（P〈0.05）。低甲状腺激素组患者合并感染和心功能不全的比例显著高于正常甲状腺激素组（P〈0.05）。结论：老年患者低甲状腺激素水平与感染和心功能不全的发生有关,甲状腺激素水平检测有助于判断感染和心功能不全严重程度及患者预后。

Objective：To investigate the changes of thyroid hormones in hospitalized elderly patients and the relationship of levels of thyroid hormones with heart failure and with infection.Methods：A total of 252 hospitalized elderly patients without hypothalamus,pituitary and thyroid diseases in Department of Geratology from September 2016 to August 2017 were included in this study.Basic demographic information and laboratory results were collected,including plasma free triiodothyronine（FT3）,free thyroxine（FT4）,thyrotropin（TSH）,procalcitonin（PCT）,hypersensitivity C-reactive protein（hs-CRP）,NT-proBNP,lactate dehydrogenase（LDH）and creatine kinase（CK）.According to levels of thyroid hormones,patients were divided into Normal Thyroid Hormone group（n=126）and Low Thyroid Hormone group（n=126）.All of those parameterswere analyzed and compared between the two groups.Results：Levels of PCT,hs-CRP,NTproBNP and LDH in the Low Thyroid Hormone group were significantly higher than those in Normal Thyroid Hormone group（P〈0.05）.The incidences of infection and cardiac dysfunction in Low Thyroid Hormone group were significantly higher than those in Normal Thyroid Hormone group（P〈0.05）.Conclusion：Levels of thyroid hormones are associated with the occurrence of infection and cardiac dysfunction in hospitalized elderly patients and the detection of thyroid hormone can be helpful in judging the severity of infection and cardiac dysfunction,as well as the prognosis of patients.