摘要
目的探讨脓毒症患者甲状腺素水平的变化及其意义。方法测定37例非甲状腺性病态综合征(NTIS)脓毒症患者、71例非NTIS脓毒症患者、47例非感染患者甲状腺功能血清总三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)、总甲状腺素(TT4)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平,记录患者年龄、性别、疾病等。另选95例健康体检者作对照组。比较NTIS脓毒症组与非NTIS脓毒症组、非感染组和对照组甲状腺功能水平的差异。结果NTIS脓毒症组血清FT3(2.63±0.29 pmol/L)、FT4(14.22±3.65 pmol/L)和TSH(1.37±1.14 m IU/L)水平与对照组比较FT3(4.67±0.41 pmol/L)、TSH(2.33±1.19 m IU/L)明显下降;FT4(12.22±1.41 pmol/L)升高,差异有统计学意义(P均<0.05)。NTIS脓毒症组血清FT3、TT3(0.54±0.18 nmol/L)、TT4(95.04±25.20 nmol/L)与非感染组比较血清FT3(3.66±0.83 pmol/L),TT3(0.96±0.43 nmol/L),TT4(105.3±20.96 nmol/L);与非NTIS脓毒症组FT3(3.61±0.49pmol/L),TT3(0.89±0.29 nmol/L),血清TT4(107.22±26.99 nmol/L)比较明显下降,差异有统计学意义(P<0.05)。结论 NTIS脓毒症患者甲状腺功能变化较明显,血清FT3和TSH水平下降,FT4水平增高,其中血清FT3是一个敏感生物标记物,对感染情况判断可能有预测价值。
Objective To explore the clinical significance of changes in serum levels of thyroid hormones in patients with sepsis. Meth-ods Thirty seven septic patients with non - thyroidal illness syndrome（NTIS）,71 septic patients without NTIS,and 47 non - septic critically ill patients were included in this study,and 95 healthy persons were selected as control group. The thyroid fuction,serum levels of total triiodothyro-nine（TT3）,free triiodothyronine（FT3）,total thyroxine（TT4）,free thyroxine（FT4）and thyrotropin - stimulating hormone（TSH）were meas-ured. Demographics and clinical characteristics of subjects were recorded. The above - mentioned indices were compared among four groups. Re-sults In comparison with heathy control group,serum levels of FT3（2. 63 ± 0. 29 vs. 4. 67 ± 0. 41 pmol/ L,P 〈 0. 05）and TSH（1. 37 ± 1. 14 vs. 2. 33 ± 1. 19 mIU / L,P 〈 0. 05）in NTIS septic group were significantly decreased . Serum levels of FT4 in patients with NTIS were higher than those of control group（14. 22 ± 3. 65 versus 12. 22 ± 1. 41 pmol/ L,P 〈 0. 05）. In NTIS septic group,serum levels of FT3（2. 63 ± 0. 29 pmol/ L）,TT3（0. 54 ± 0. 18 nmol/ L）and TT4（95. 04 ± 25. 20 nmol/ L）were significantly lower than those of non - sepsis group（3. 66 ± 0. 83pmol/ L,0. 96 ± 0. 43 nmol/ L,105. 3 ± 20. 96 nmol/ L）and sepsis without NTIS group（3. 61 ± 0. 49 pmol/ L,0. 89 ± 0. 29 nmol/ L,107. 22 ± 26. 99 nmol/ L,all P 〈 0. 05）. Conclusion Septic patients with NTIS have profound changes in thyroid function,including decreased serum lev-els of FT3 and TSH and increased serum level of FT4. Serum level of FT3 is a sensitive biomarker for predicting the status of infection.
出处
《临床和实验医学杂志》
2016年第13期1265-1268,共4页
Journal of Clinical and Experimental Medicine
基金
首都医科大学基础临床合作研究基金(项目批准号15JL-L04)
