心脏外科术后重症患者正常甲状腺病态综合征研究进展

Research progress of euthyroid sick syndrome in severe patients after cardiac surgery

心脏外科患者往往因原发病危重、手术创伤大、术后早期严重并发症等导致危重症状态,严重影响手术效果及生存率,是目前心脏外科医师亟待解决的重大难题。甲状腺激素影响着机体各系统、器官的功能以及物质、能量代谢,在危重患者的应激反应和修复过程中发挥重要作用。正常甲状腺病态综合征(ESS)是心脏外科术后并发症之一,在重症患者中更为常见。心脏外科术后并发ESS对患者预后的影响及对ESS的干预效果一直备受争议,更多研究认为对ESS的诊疗有助于改善危重患者的预后。本文对ESS的发病机制、与心脏外科术后重症患者的关系及ESS的治疗对心脏外科术后重症患者结局的影响进行综述。

Patients in department of cardiac surgery often suffer from critical conditions,such as severe primary illness,surgical trauma and early postoperative complications,its serious impact on surgical effect and survival rate make it an important problem to be resolved urgently by heart surgeons.Thyroid hormone affects the function of every system and organ,metabolism of material and energy,and plays an important role in the stress response and repair process of critically ill patients.Euthyroid sick syndrome(ESS)is one of the complication after cardiac surgery and happens more common in severe patients.The influence of ESS after cardiac surgery on the prognosis of patients and the intervention effect of ESS have been controversial.More studies believe that the diagnosis and treatment of ESS can help to improve the prognosis of critically ill patients.This article reviews the pathogenesis of ESS,its relationship with critical patients after cardiac surgery,and the impact of ESS treatment on the outcome of critical patients after cardiac surgery.