老年住院患者低三碘甲状腺原氨酸综合征临床特征及其危险因素研究

Study of clinical characteristics and risk factors of low T3 syndrome in elderly inpatients

目的了解老年住院患者低三碘甲状腺原氨酸(T3)综合征的临床特征,探索低T3综合征的危险因素。方法采用横断面调查,纳入符合条件的老年住院患者934例,测定血清T3、游离T3(FT3)、甲状腺素(T4)、游离T4(FT4)、促甲状腺素(TSH)、总蛋白、白蛋白、空腹血糖(FBG)、脑钠肽(BNP)、C反应蛋白(CRP)、红细胞、血红蛋白、白细胞等生化临检指标,对2组基线资料进行单因素分析,应用Logistic多因素回归分析低T3综合征的危险因素。结果934例患者低T3综合征组78例,甲状腺功能正常组856例。低T3综合征组年龄、脑出血史、冠心病史、慢性肾脏病史、肿瘤史、肺部感染史、尿路感染史、肌酐、尿素氮、WBC、FBG、,CRP和BNP水平均显著高于甲状腺功能正常组(P均<0.01),红细胞、血红蛋白、总蛋白、白蛋白、前白蛋白、胆固醇和甘油三酯低于甲状腺功能正常组(P均<0.01),多因素Logistic回归分析显示,低ALB和高CRP是低T3综合征的危险因素(OR=6.138,8.271,P均<0.01)。结论低ALB和高CRP是低T3综合征的危险因素。

Objective To understand the clinical characteristics of low T3 syndrome in elderly inpatients and to explore the risk factors of low T3 syndrome.Methods A cross-sectional survey was carried out in 934 elderly inpatients,who were included in the survey.Serum triiodothyronine(T3),free T3(FT3),thyroxine(T4),free T4(FT4),thyrotropin(TSH),total protein(TP),albumin(ALB),fasting blood glucose(FBG),brain natriuretic peptide(BNP),C-reactive protein(CRP),red blood cell(RBC)were measured.Single factor analysis was conducted on the baseline data of the two groups,and Logistic multiple factor regression was used to analyze the risk factors of low T3 syndrome.Results There were 78 cases in low T3 syndrome group and 856 cases in normal thyroid function group.The age,the percentages of cerebral hemorrhage,coronary heart disease,chronic kidney,tumor,pulmonary infection,urinary tract infection history,levels of creatinine,urea nitrogen,WBC,FBG,CRP and BNP in the low T3 syndrome group were significantly higher than those in the normal thyroid function group(all P<0.01),and the levels of red blood cells,hemoglobin,total protein,albumin,prealbumin,cholesterol and triglyceride were lower than those in the normal thyroid function group(all P<0.01).Multivariate Logistic regression analysis showed that low ALB and high CRP were the risk factors of low T3 syndrome(OR=6.138,8.271,all P<0.01).Conclusion Low ALB and high CRP are the risk factors of low T3 syndrome.