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血清甲状腺激素水平对脓毒症休克患者的预后评估
引用本文:杜娟,白云升,高伟良,冯清州,左右.血清甲状腺激素水平对脓毒症休克患者的预后评估[J].新乡医学院学报,2012,29(1):55-56,61.
作者姓名:杜娟  白云升  高伟良  冯清州  左右
作者单位:1. 深圳市第七人民医院ICU科,广东深圳,518081
2. 暨南大学第二临床医学院呼吸内科,广东深圳,518083
摘    要:目的探讨脓毒症休克患者的血清甲状腺素水平与病情严重程度、预后及急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)和序贯器官衰竭评分(SOFA)的关系。方法对53例诊断为脓毒症休克患者的资料进行回顾性分析,根据预后分为存活组(n=38)和死亡组(n=15)。分别在入住重症监护病房后第1个24 h内检测血清甲状腺激素水平并结合APACHEⅡ和SOFA系统进行评分。结果死亡组患者血清三碘甲状腺原氨酸(T3)、游离T3(FT3)、甲状腺素(T4)、游离T4(FT4)水平明显低于存活组(P<0.05);死亡组患者血清T4水平与APACHEⅡ和SOFA评分呈负相关(r1=-0.53,P<0.01;r2=-0.35,P<0.01)。结论血清T4水平可作为脓毒症休克患者预后的早期预测指标。

关 键 词:脓毒症休克  正常甲状腺功能病态综合征  急性生理与慢性健康状况评分  序贯器官衰竭评分

Investigation of serum thyroid hormone levels on the prognosis of septic shock
DU Juan , BAI Yun-sheng , GAO Wei-liang , FENG Qing-zhou , ZUO You.Investigation of serum thyroid hormone levels on the prognosis of septic shock[J].Journal of Xinxiang Medical College,2012,29(1):55-56,61.
Authors:DU Juan  BAI Yun-sheng  GAO Wei-liang  FENG Qing-zhou  ZUO You
Institution:1(1.Intensive Care Unit,the Seventh People′s Hospital of Shenzhen,Shenzhen 518081,Guangdong Province,China;2.Department of Respiratory Medicine,the Second Clinical Medicial College of Jinan University,Shenzhen 518083,Guangdong Province,China)
Abstract:Objective To investigate the relationship between the serum thyroid hormone levels and the severity,prognosis of patients with septic shock and sequential organ failure assessment(SOFA) scores,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) scores.Methods The clinical data of fifty-three patients with septic shock were retrospectively analyzed.The patients were divided into survival group(n=38) and nonsurvival group(n=15) according to the prognosis.All the patients in hospital were detected serum thyroid hormone levels in 24 hours,and were evaluated by APACHE Ⅱand SOFA scores.Results The levels of serum triiodothyronine,free triiodothyronine,tetraiodothyronine,free tetraiodothyronine in nonsurvival group were significantly lower than the survival group(P<0.05).The level of serum tetraiodothyronine in nonsurvival group has negative correlation with APACHE Ⅱ and SOFA scores(r1=-0.53,P<0.01;r2=-0.35,P<0.01).Conclusion The levels of serum tetraiodothyronine in patients with septic shock can be used as an early predictor for prognosis.
Keywords:septic shock  euthyroid sick syndrome  acute physiology and chronic health evaluation  sequential organ failure assessment
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