重症急性胆管炎和重症急性胰腺炎甲状腺激素变化的意义

目的研究重症急腹症患者机体内分泌激素的变化。方法对２７例重症急性胆管炎（ＡＣＳＴ）（Ａ组）和２１例重症急性胰腺炎（ＳＡＰ）（Ｂ组）患者围手术期甲状腺激素变化进行了观测，并与１２０例胆囊结石（Ｃ组）患者对照。结果术前Ａ，Ｂ组Ｔ３水平显著低于Ｃ组（Ｐ＜０．０１）。Ａ，Ｂ组术后Ｔ３显著高于术前（Ｐ＜０．０１）。术前及术后Ａ组Ｔ３均显著低于Ｂ组（Ｐ＜０．０５，Ｐ＜０．０１）。２例死亡的ＡＣＳＴ患者，术前Ｔ３均低于０４６ｎｍｏｌ／Ｌ，术后仍低于０８５ｎｍｏｌ／Ｌ。结论甲状腺激素变化可作为判断感染程度和预后指标之一。

Significance of alternation of thyroid hormones in patients with severe acute cholangitis and severe acute pancreatitis

Objective To study the alternation of endocrine hormone in patients with acute abdomen. Methods Perioperation thyroid hormones was observed in 27 patients with severe acute cholangitis (ACST, group A), 21 patients with severe acute pancreatitis (SAP, gorup B), and 120 patients with gallstones (group C). Results Triiodothyronine (T 3) level in group A and group B was significantly lower than that in group C ( P <0.01) before operation. T 3 level in group A and group B after operation was significantly higher than that before operation ( P <0.01). T 3 level in group A was significantly lower than that in group B both before and after operation ( P <0.05, P <0.01). Two patients with ACST died whose T 3 was lower than 0.46nmol/L before operation and lower than 0.85nmol/L after operated. Conclusions Alternation of T 3 may be as an index for evaluation of severity and prognosis of patients with infections disease.