老年卧床感染患者非甲状腺病态综合征的临床分析

Clinical analysis of non-thyroidal illness syndrome in elderly bedridden patients with infection

目的探讨老年卧床感染患者甲状腺激素(TH)、降钙素原(PCT)与病情严重程度及预后的关系。方法回顾性分析于2017年1～10月我院收治的57例老年卧床感染患者,收集所有患者的临床资料。将入选病例分为卧床组和对照组。卧床组按照患者的住院病死率分为生存组和死亡组。生存组按照疾病状态分为患病时和病愈后。测定各组患者的TH及PCT,并行各组间统计学分析。结果 (1)与对照组比较,卧床组患者TT3、TT4、FT3均明显降低,PCT明显升高,差异有统计学意义(P<0.05)。(2)死亡组患者TT3、TT4、FT3水平降低,PCT明显升高,差异有统计学意义(P<0.05)。(3)生存组患者患病时与病愈后TT3、TT4、FT3、FT4、PCT水平比较,差异有统计学意义(P<0.05)。(4)TT3、PCT是老年卧床感染患者死亡的独立危险因素(OR=1.065、1.948)。结论老年卧床感染患者中存在非甲状腺功能病态综合征,患病时甲状腺激素明显低于病愈后的甲状腺激素。TT3与PCT可作为疾病严重程度及预后不良的指标。

Objective To investigate the relationship between thyroid hormone(TH),procalcitonin(PCT)in elderly patients and severity of disease and prognosis.Methods A retrospective study was performed on57elderly patients with bedridden infection admitted in our hospital from January to October2017.The clinical data of all patients were collected.The selected cases were divided into bedridden group and control group.The bedridden patients were divided into the survival group and the death group according to the hospital mortality rate.The survival group was divided into diseased and post-healed group according to the disease state.The TH and PCT of each group of patients were measured,and statistical analysis was performed between the groups.Results(1)Compared with those of the control group,TT3,TT4and FT3in the bedridden group were significantly lower,and PCT was significantly increased,and the difference was statistically significant(P<0.05).(2)The levels of TT3,TT4and FT3in the death group were significantly decreased,and the PCT was significantly increased,and the difference was statistically significant(P<0.05).(3)There were significant differences in the levels of TT3,TT4,FT3,FT4and PCT in the survival group when sick and after the illness(P<0.05).(4)TT3and PCT are independent risk factors for death in elderly bedridden patients with infection(OR=1.065,1.948).Conclusion There is a non-thyroidal illness syndrome in elderly patients with bed-infested infection.The thyroid hormone when sick is significantly lower than the thyroid hormone after recovery.TT3and PCT can be used as indicators of disease severity and poor prognosis.