甲状腺功能对危重症患者预后的评估价值

Evaluation Value of Thyroid Function on Prognosis of Critically Ill Patients

目的:探讨甲状腺功能对危重症患者预后的评估价值。方法:筛选2019年5月-2021年5月湖南省人民医院ICU患者500例,按照APACHEⅡ评分进行四分位数分组,分为A组、B组、C组、D组,观察各组甲状腺功能变化情况。结果:A组、B组、C组、D组之间血清游离甲状腺素(FT_(4))水平比较,差异无统计学意义(P>0.05);与A组比较,C组和D组血清游离三碘甲状腺原氨酸(FT_(3))水平较低,差异有统计学意义(P<0.05),与B组比较,D组FT_(3)水平偏低,差异有统计学意义(P<0.05);与D组比较,A组和C组FT_(3)/FT_(4)比值较高,差异有统计学意义(P<0.05);与A组比较,D组血清促甲状腺素(TSH)水平较低,差异有统计学意义(P<0.05)。相关分析显示FT_(3)、FT_(3)/FT_(4)比值、TSH与APACHEⅡ评分呈负相关,而FT_(4)水平与APACHEⅡ评分无显著相关性。结论:甲状腺功能与APACHEⅡ评分存在相关性,APACHEⅡ评分越高,FT_(3)、FT_(3)/FT_(4)比值、TSH水平越低,患者病情更重,说明FT_(3)、FT_(3)/FT_(4)比值、TSH指标可用于评估危重症患者的疾病严重程度及预后。

Objective:To explore the evaluation value of thyroid function on the prognosis of critically ill patients.Methods:A total of 500 patients who were admitted to the ICU of Hunan Provincial People's Hospital from May 2019 to May 2021 were screened.According to the APACHE II score with quartile method,they were divided into groups A,B,C,and D.Thyroid function change in each group was compared.Results:There was no statistically significant difference in FT_(4)levels between groups A,B,C,and D(P>0.05);compared with group A,the FT_(3)levels of groups C and D were lower,and the difference was statistically significant(P<0.05);compared with group B,the FT_(3)level of group D was relatively lower,with statistically significant difference(P<0.05);compared with group D,the FT_(3)/FT_(4)ratios of groups A,and C were higher,and the difference was statistically significant(P<0.05);compared with group A,the TSH level of group D was lower,and the difference was statistically significant(P<0.05).Correlation analysis showed that FT_(3),FT_(3)/FT_(4)ratio,TSH were negatively correlated with APACHEⅡscore,while FT_(4)level and APACHEⅡscore were not significantly correlated.Conclusion:There is a certain correlation between thyroid function and APACHEⅡscore.The higher APACHEⅡscore indicates the lower levels of FT_(3),FT_(3)/FT_(4)ratio,and TSH,as well as the severer patient's condition.The FT_(3),FT_(3)/FT_(4)ratio,and TSH indicators can be used to assess the severity of the disease and prognosis in critically ill patients.