脓毒症患者甲状腺激素水平与预后的关系

Relationship between Thyroid Hormone Level and Prognosis in Patients with Sepsis

目的探讨脓毒症患者甲状腺激素水平与预后恢复的关联性。方法选择2017年5月至2018年11月蚌埠市第三人民医院收治的24例脓毒症患者作为A组,另外选取同时期24例ICU未合并脓毒症患者作为B组。使用罗氏601电化学发光免疫分析仪测定并比较两组三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)等甲状腺激素指标水平,应用急性生理学及慢性健康状况评分系统(APACHEⅡ评分)评估并比较两组患者入住ICU 24 h内的急性生理与慢性健康进行评价。结果与B组比较,A组T3、T4、FT3、FT4指标均明显更低,差异有统计学意义(P<0.05)。A组APACHEⅡ评分为(16.14±2.69)分,高于B组的(11.49±2.03)分,差异有统计学意义(P<0.05)。结论脓毒症患者甲状腺激素水平呈现明显的下降趋势,APACHEⅡ评分则呈现明显的增加趋势,通过甲状腺激素水平的变化判断脓毒症患者的预后情况,具有重要的临床价值。

Objective To investigate the relationship between thyroid hormone levels and prognosis in patients with sepsis.Methods Twenty-four patients with sepsis admitted to the Third People's Hospital of Bengbu City from May 2017 to November 2018 were selected as group A,and patients with concurrent ICU without sepsis were selected as group B.Two groups of triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3),free tetraiodothyronine were measured and compared using a Roche 601 electrochemiluminescence immunoassay analyzer.The levels of thyroid hormones such as FT4 were evaluated by acute physiology and chronic health status scoring system(APACHE II score)and the acute and chronic health of the two groups were compared within 24 hours of ICU.Results Compared with group B,the T3,T4,FT3 and FT4 indexes in group A were significantly lower,and the difference was statistically significant(P<0.05).The APACHE II score of group A was(16.14±2.69),which was higher than that of group B(11.49±2.03),and the difference was statistically significant(P<0.05).Conclusion The thyroid hormone level of patients with sepsis shows a significant downward trend,and the APACHE II score shows a significant increase trend.It is of great clinical value to judge the prognosis of patients with sepsis by the change of thyroid hormone level.