急性呼吸窘迫综合征病人甲状腺激素水平对预后的影响

Effect of the thyroid hormone level on the prognosis of patients with acute respiratory distress syndrome

目的:探究急性呼吸窘迫综合征(ARDS)病人血清三碘甲状腺原氨酸(T3)水平与预后的关系。方法:选取40例ARDS病人作为研究对象,根据住院30 d的结局分为存活组和死亡组。比较2组病人入院年龄、APACHEⅡ评分、降钙素原、超敏C反应蛋白、白细胞计数、p H、乳酸、游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素水平,并分析影响住院30 d结局的因素。结果:死亡组FT3水平在诊断ARDS第1天明显低于存活组(P <0. 05);动态监测甲状腺激素水平,存活组第1天的FT3和促甲状腺激素均明显低于第3天(P <0. 01),死亡组甲状腺激素水平均无明显改变(P> 0. 05)。多因素logistic回归分析显示,住院30 d的结局(死亡或存活)影响因素为血清FT3水平和APACHEⅡ评分(P <0. 05)。结论:甲状腺激素水平的检测有助于评估ARDS严重程度及其预后。

Objective: To investigate the effects of triiodothyronine 3( T3) level on the prognosis of patients with acute respiratory distress syndrome( ARDS). Methods: Forty patients with ARDS were divided into the survival group and death group according to the hospitalization 30 days outcome. The age,APACHE Ⅱ score,levels of Calcitonin,hypersensitive c-reactive protein,white blood cell count,p H,lactic acid,FT3,free thyroxine and thyroid-stimulating hormone between two groups were compared,and the influencing factors of hospitalization 30 days outcome were analyzed. Results: The level of T3 in death group was significantly lower than that in survival group on the first day of ARDS diagnosis( P < 0. 05). The level of T3 on the first day in survival group was significantly lower than that on the third day( P < 0. 01),and no obvious change in T3 level was found in death group( P > 0. 05). The results of multivariate logistic regression analysis showed that the FT3 level and APACHEⅡ score were the influencing factors of hospitalization30 days outcome( P < 0. 05). Conclusions: The detection of T3 level can help to assess the severity of ARDS,and predict the prognosis of patients.