摘要
目的研究心脏骤停(CA)患者心肺复苏(CPR)成功后甲状腺激素水平的变化,并分析其与炎症反应的关系。方法选取经CPR成功并存活≥12h的CA患者31例,测定外周血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)及TT_3、TT_4、游离T_3(FT_3)、游离T_4(FT_4)、促甲状腺激素(TSH)水平,按hs-CRP、PCT结果分为hs-CRP、PCT升高组及对照组,比较两组甲状腺激素水平的差异,并分析hs-CRP、PCT与甲状腺激素的相关性。对出现非甲状腺疾病综合征(NTIS)与未出现NTIS进行累积生存率观察。结果 hs-CRP升高组TT3、FT3、TSH均低于hs-CRP对照组(均P<0.05),但TT4、FT4之间比较差异均无统计学意义(均P>0.05),PCT升高组TT_3、FT_3、TT_4、FT_4、TSH与PCT对照组之间比较差异均无统计学意义(均P>0.05),TT_3、FT_3、TSH与hs-CRP均呈负相关,与PCT无相关(P>0.05);未出现NTIS组累积生存率高于NTIS组(P<0.05)。结论 CA患者CPR成功后出现甲状腺激素水平降低,且炎症反应越严重甲状腺激素水平下降越明显。
Objective To investigate the thyroid hormone levels in patients with cardiac arrest(CA) after cardiopulmonary resuscitation(CPR), and its relation to inflammatory response. Methods Thirty one patients with CA after CPR who survived for more than12 h were included in the study. Serum of high sensitivity C reactive protein(hs-CRP), procalcitonin(PCT), total triiodothyronine(TT_3),thyroxine(TT_4), free triiodothyronine(FT_3), free thyroxine(FT_4) and thyroid-stimulating hormone(TSH) levels were tested. The correlation of thyroid hormone levels with hs-CRP and PCT was analyzed. The cumulative survival rates of patients with nonthyroid illness syndrome(NTIS)and without NTIS were observed. Results The TT_3, FT_3 and TSH levels in patients with increased hs-CRP were lower than those in controls(P<0.05), but there were no significant differences in TT_4 and FT_4 between two groups(P >0.05). There were no significant differences in TT_3, FT_3, TT_4, FT_4 and TSH levels between patients with increased PCT and the controls(P >0.05). TT_3, FT_3, TSH levels were negatively correlated with hs-CRP, but not correlated with PCT levels. The cumulative survival rate in patients without NTIS was higher than that in those with NTIS(P <0.05). Conclusion The thyroid hormone levels are decreased in patients with cardiac arrest after cardiopulmonary resuscitation, and the levels are negatively correlated with the severity of inflammatory response of the patients.
作者
夏金明
赖登攀
吕世进
魏霞
XIA Jinming;LAI Dengpan;LYU Shijin;et al(Department of Emergency, Affil iated Hospital of Hangzhou Normal University, Hangzhou 310015, China)
出处
《浙江医学》
CAS
2018年第1期50-53,共4页
Zhejiang Medical Journal
基金
浙江省医药卫生科技计划项目(2015KYB300)
关键词
心脏骤停
心肺复苏
非甲状腺疾病综合征
炎症反应
Cardiac arrest
Cardiopulmonary resuscitation
Nonthyroid illness syndrome
Inflammatory response
