非甲状腺病态综合征与脓毒症严重程度及临床预后的关系

The role of non-thyroid illness syndrome in the severity and prognosis of sepsis

目的探讨非甲状腺病态综合征(non-thyroid illness syndrome,NTIS)与脓毒症严重程度及临床预后的关系。方法搜集2015年9月至2018年2月因脓毒症在我院急诊科住院的110例患者进行回顾性分析,根据入院时是否存在NTIS,分为NTIS组和甲状腺功能正常组,比较两组入院时的基线资料和序贯器官衰竭评估(SOFA)评分,分析比较两组患者28 d生存曲线、临床稳定时间和是否需要器官功能支持。结果两组患者的基线资料比较差异无统计学意义,但NTIS组SOFA评分更高(分:4.54±1.81 vs.3.76±1.38,P<0.05),28 d病死率更高(23.3%vs.5.4%,P<0.05),临床稳定时间更长(d:9.05±6.22 vs.5.37±2.88,P<0.01),需要器官功能支持的风险更高(特别是肾脏替代治疗,P<0.05)。结论合并NTIS的脓毒症患者病情更重,预后更差,需要器官功能支持的风险更大。脓毒症患者需普及甲状腺激素水平的检查。

Objective To evaluate the role of non-thyroid illness syndrome(NTIS)in the severity and prognosis of sepsis.Methods A total of 110 patients with sepsis admitted to the emergence medical ward of our hospital from September 2015 to February 2018 were included in our study.We adopted retrospective method to analyze patients,situations by statistical software.The patients were divided into NTIS group and those of normal group according to their thyroxin level on admission.We assessed the differences of baseline data and sequential organ failure assessment(SOFA)score between the two groups.We further analyzed 28-day Kaplan-Meier curve,clinical stabilization time and organ support needs between the two groups.Results There were no significant differences in baseline data.However,SOFA scores of NTIS group were significantly higher than those of normal group(score:4.54±1.81 vs.3.76±1.38,P<0.05).Meanwhile,28-day mortality of NTIS group was higher than that of normal group patients(23.3%vs.5.4%,P<0.05)as well.Furthermore,clinical stabilization time of NTIS group was higher than that of normal group(d:9.05±6.22 vs.5.37±2.88,P<0.01).Besides,NTIS group tended to high risk for organ support therapy especially renal replacement therapy.Conclusion NTIS with sepsis indicates more serious illness and worse prognosis.Thyroid hormone level test should be popularized in septic patients.