摘要
目的探讨危重症患者血清甲状腺激素、皮质醇的变化规律,与病情的关系及其临床意义。方法应用化学发光法测定51例患者入ICU后第1天及2天后仍存活的45例患者第3天的血清甲状腺激素、促甲状腺激素和皮质醇(COR)的水平。入ICU后2 d存活的45例患者中,17例伴有多器官功能障碍综合征(MODS组),28例不伴MODS(非MODS组)。在入ICU第1天记录所有患者的年龄、血糖和APACHEⅡ评分。结果存活的45例患者中41例(91％)血清FT3水平下降,33例(73％)血清皮质醇水平升高,在疾病最初的24 h更加明显。MODS组各项指标比非MODS组变化显著。6例死亡患者血清FT4下降明显。血清FT3水平与APACHEⅡ呈负相关,COR水平与APACHEⅡ呈正相关。结论危重症患者血清甲状腺激素和皮质醇水平与疾病的严重程度相关, MODS组各激素变化比非MODS组显著;血清FT4的下降程度与病情危重程度一致,可能作为判断预后的指标。
Objective To investigate the profile and significance of changes in thyroid function and cortisol in critically ill patients. Methods Chemiluminescent microparticle immunoassay （CMIA） was used to measure the serum thyroid hormone, thyroid stimulating hormone and cortisol levels in 51 patients at the first day and in the 45 patients still alive at the third day after hospitalized in ICU. In the 45 patients, 17 cases were complicated with multiple organ dysfunction syndrome （MODS） and 28 cases were not. The age, blood glucose levels and APACHE U scores were also recorded at the first day. Results In the 45 patients, serum FT3 decreased in 41 patients （91% ）, cortisol increased in 33 patients （73%）, especially in the first 24 hours. Compared with non-MODS group, serum FT3 ,FT4 and cortisol levels changed significantly in MODS group. Serum FT4 reduced apparently in 6 dead patients. Serum FT3 level was negatively correlated with APACHE Ⅱ, and cortisol level was positively correlated with APACHE Ⅱ. Conclusions Thyroid hormone and cortisol were apparently abnormal and correlated with APACHE Ⅱ score, especially in patients with MODS. Serum FT4 might serve as an index to judge the prognosis of the patients.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2006年第17期1203-1205,共3页
Chinese Journal of Surgery
