重型颅脑创伤后患者血清甲状腺激素水平对病情严重程度及死亡率的影响

 摘要：目的  探讨重型颅脑创伤后患者血清甲状腺激素水平对病情严重程度及死亡率的影响。方法  选取2013年1月-2015年1月在该院住院的重型颅脑创伤患者75例为观察组，另随机选取同期体检健康居民50例作为对照组，采用格拉斯哥昏迷评分（GCS）评估颅脑创伤严重程度，化学发光法检测血清甲状腺激素水平，计算住院患者死亡率，比较两组血清甲状腺激素水平差异，血清甲状腺激素水平对GCS评分、死亡率的影响。结果  重型颅脑创伤患者血清（FT3）、总甲状腺激素（TT3）水平与对照组比较，差异有统计学意义（P <0.05）；重型颅脑创伤患者血清游离三碘甲状腺原氨酸（FT3）、总甲状腺素（TT3）水平与病情严重程度呈正相关（r =0.455和0.405，P =0.000）；重型颅脑创伤患者血清FT3、TT3水平影响死亡率（P <0.05）。结论  重型颅脑创伤患者急性期甲状腺激素水平变化明显，血清FT3、TT3水平越低，病情越严重，死亡率越高。

Effect of serum thyroid hormone levels on mortality and severity of patients with severe traumatic brain injury

Abstract: Objective To investigate the effect of serum thyroid hormone levels on mortality and severity of patients with severe traumatic brain injury. Methods Seventy-five patients with severe traumatic brain injury who were hospitalized in Tangshan Gongren Hospital from January 2013 to January 2015 were selected as the patient group, and 50 people without thyroid disease at the same period were recruited as the control group. Glasgow Coma Scale (GCS) was applied to assess the severity of severe traumatic brain injury. Serum thyroid hormone levels were detected by chemiluminescence method. The mortality was calculated. Serum thyroid hormone levels were compared between the two groups. The effect of serum thyroid hormone levels on mortality and severity of the patients with severe traumatic brain injury was analyzed. Results Serum free triiodothyronine (FT3) and total thyroxine (TT3) levels of the patient group were lower than those of the normal control group (P < 0.05). Serum FT3 and TT3 levels were both correlated with the severity of the patients (P < 0.05); moreover, serum FT3 and TT3 levels affected the mortality of the patients with severe traumatic brain injury. Conclusions Serum thyroid hormone levels significantly alter in the acute period of the patients with severe traumatic brain injury. The lower the serum FT3 and TT3 levels, the severer the patients'' condition, and the higher the mortality of the patients.