严重烧伤患者甲状腺功能变化的调查与分析

 目的 分析严重烧伤患者甲状腺功能（简称甲功）变化, 评价甲功检测对治疗烧伤患者的意义。方法 回顾性分析114例严重烧伤患者入院当天、第3天、第5天、第7天、第14天、第20天甲功五项变化。根据年龄情况将研究对象分为老年组、中年组和青少儿组, 以30例健康体检人群做对照组。检测仪器应用全自动化学发光分析仪Centaur CP。结果 严重烧伤老年组患者血清FT₃、FT₄值较对照组均明显降低（P＜0.05或P＜0.01）, 血清FT₃从伤后当天开始下降, 血清FT₄下降稍迟, 伤后第3天开始下降；而血清TSH、aTG、aTPO值较对照组明显升高（P＜0.05或P＜0.01）, 其中血清TSH值在伤后第7天达到高峰。严重烧伤中年组患者甲功五项结果与对照组比较无明显差异（P>0.05））, 血清aTG、aTPO有上升趋势。严重烧伤青少儿组患者血清FT₃、FT₄、TSH值与对照组比较无明显差异（P>0.05）, 而血清aTG、aTPO值与对照组比较增高（P＜0.01）, 其中aTPO值上升更加明显。结论 监测严重烧伤患者甲功五项对于临床医师了解和救治烧伤患者有非常重要的指导意义。

Investigation and analysis of changes in thyroid function in severely burned patients

Objective To analyze thyroid function changes in severe burn patients and to evaluate the thyroid function testing in treatment of burn patients. Methods 114 severe burn patients in this hospital from July 2007 to April 2012 were recruited. The five items of thyroid function testing on day 1, 3, 5, 7, 14, and 20 were conducted. According to the age, the patients were divided into the elderly group, middle aged group and young group, with 30 healthy subjects as control group. Automatic detecting instrument of chemiluminescence analyzer Centaur CP was used. Results Serum FT₃, FT₄ values in elderly group were significantly lower than in the control group (P<0.05 or P<0.01). Serum FT₃ began to decline from day 1, serum FT₄ began to decline from day 3; and the serum TSH, aTG, aTPO values were higher than those in the control group (P<0.05 or P< 0.01), in which the value of serum TSH reach the peak on day 7. Five results of severe burn patients in middle age group compared with the control group had no significant differences, serum aTG, aTPO had a tendency to rise. Serum FT₃, FT₄, TSH values in severe burn children group compared with the control group had no significant difference, and the serum aTG, aTPO values compared with the control group increased (P<0.01), in which the aTPO value increased more markedly. Conclusions It is important to test thyroid function changes in severe burn patients.