摘要
目的探讨老年危重症全身炎症反应综合征(SIRS)患者甲状腺激素的变化及其与预后的关系。方法回顾分析60例老年危重症SIRS患者的临床资料,进行APACHEII评分,根据预后分成死亡组与存活组,比较2组甲状腺激素的水平。结果老年危重症SIRS患者病情越严重的,血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)下降越明显,与APACHEII评分负相关,死亡组FT3、FT4水平明显低于存活组。结论炎症反应和细胞因子对甲状腺轴具有一定影响,FT3、FT4水平可以反映老年危重症SIRS患者的病情,低FT3、FT4水平患者易发生MODS而死亡。
Objective To study the changes of thyroid hormone levels of elderly patients with severe systemic inflammatory response syndrome (SIRS) and prognosis in old patients with SIRS. Methods Sixty elderly severe patients with SIRS, 32 males and 28 females, aged 69.3±8.5(60～95), with a APACHEⅡ score of 23.4±9.6(15～36),were divided into 2 groups: Group A(n=34)with multiple organs dysfunction syndrome (MODS), and Gropup B(n=26) without MODS. 23 of the 60 patients died, and 37 patients were on the mend. The clinical data were analyzed. Peripheral blood samples were collected the next day after hospitalization to undergo the examination of triiodothyronine(TT3), total thyroxine(TT4), free serum triiodothyroxine(FT3), and free thyroxine(FT4). TSH, thyroid hormone levels were compared between death group and survival group. Results The TT3 and FT3 levels decreased in 57 patients. The TT4 and FT4 levels decreased in 52 patients. The TT3, TT4, and FT3 levels of the MODS group were significantly lower then those of the non-MODS group (all P<0.05), and the APACH Ⅱ score of the MODS group was 25.4±9.3, significantly higher than that of ther non-MODS group. The TT3, TT4, and FT3 levels of the “death”group were all lower than those of the “survival” group (all P<0.05),and the APACH Ⅱ score of the MODS group was 26.2±8.9, significantly higher than that of ther “survival”group(19.1±7.5). TSH level was decreased in 24 patients and was normal in 36 patients. Compared with the patients with normal TSH, those with lower TSH had lower T3 and T4 levels, higher APACHEⅡ scores, and a higher proportions of members of the MODS and “death” groups, however, not significantly(all P>0.05). Conclusion When the condition of the elderly patients with severe SIRS worsens the levels of thyroid hormones, especially FT3 and FT4, would become lower.There is a negative correlation between thyroid hormone levels and APACHEⅡscore.
出处
《中国急救复苏与灾害医学杂志》
2007年第5期264-265,268,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
全身炎症性反应综合征
甲状腺激素
多脏器功能障碍综合征
Systemic inflammatory response syndrome
Thyroid hormones
Multiple organs dysfunction syndrome
