摘要
目的调查了解ICU危重症患者垂体和甲状腺激素水平差异,并进一步分析激素水平与性别、脑部病变、APACHEⅡ评分的相关性。方法选择2013年1月—2018年6月淮南市新华医院ICU病房收治的120例患者,采用APACHEⅡ评分对疾病严重程度予以评估,对其血清中的促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离三碘甲状腺原氨酸(FT4)、生长激素(GH)进行检测。按照性别、是否存在颅脑损伤及脑血管病变、APACHEⅡ评分进行分组,比较男性组与女性组、脑部病变组与非脑部病变组、APACHEⅡ评分≤15分组与APACHEⅡ评分>15分组的激素水平,并采用皮尔逊相关系数分析法,分析激素水平与危重症患者性别、脑部病变、APACHEⅡ评分的相关性。结果男性组的FT3高于女性组;脑部病变组的FT3、FT4高于非脑部病变组;APACHEⅡ评分>15分组FT3、FT4水平低于APACHEⅡ评分≤15分组。相关性分析结果显示,FT3与ICU危重症患者的性别相关;FT3与ICU危重症患者有无脑部病变相关;FT3与APACHEⅡ评分呈负相关。结论除性别差异外,FT3与ICU危重症患者的脑部病变、APACHEⅡ评分相关,FT3可间接反映患者疾病的严重程度,预测高危风险,临床可以考虑将FT3作为颅脑损伤患者的病情轻重的评估指标。
Objective To investigate the difference of pituitary and thyroid hormone levels in ICU critical patients and further analyze the relationship between hormone levels and gender,brain lesions,acute physiology and chronic health status(APACHEⅡ)scores.Methods A total of 120 critically ill patients admitted to the ICU ward of our hospital from January 2013 to June 2018 were enrolled.The APACHEⅡscore was used to assess the severity of the disease.The thyrotropin(TSH),free triiodothyronine(FT3),free tetraiodothyronine(FT4),and growth hormone(GH)in the ser-um were tested.The hormone levels of the male group and the female group,brain lesion group and non brain lesion group,ApacheⅡscores≤15 group and ApacheⅡscores>15 group were compared according to gender,presence or absence of brain injury and cerebrovascular disease,ApacheⅡscore.The correlation between hormone level and gen-der,brain lesions,ApacheⅡscore in critical patients were analyzed by Pearson correlation coefficient analysis.Results The FT3 of the male group were higher than that of the female group(P<0.05).The FT3 and FT4 of the craniocerebral injury group were higher than those in the non craniocerebral injury group(P<0.05).The FT3 and FT4 levels in the APACHEⅡscores>15 group were lower than those of APACHEⅡscores≤15 group(P<0.05).The re-sults of correlation analysis showed that FT3 was correlated with the gender and craniocerebral injury of ICU critical pa-tients,and negatively correlated with their APACHEⅡscores.Conclusion In addition to gender differences,FT3 is related to the brain lesions and APACHEⅡscores of ICU critical patients.The FT3 can indirectly reflect the severity of the disease and predict the high-risk risk.Thyroid hormone can be used as the evaluation indexes of the severity of craniocerebral injury.
作者
丁智
吴强
DING Zhi;WU Qiang(Department of Critical Medicine,Xinhua Hospital,Huainan,Anhui 232000,China)
出处
《中华全科医学》
2020年第8期1307-1309,共3页
Chinese Journal of General Practice
基金
安徽省高校省级自然科学基金研究项目(KJ2015B002BY)。
关键词
重症监护室
颅脑损伤
甲状腺激素
生长激素
Intensive care unit
Craniocerebral injury
Thyroid hormone
Growth hormone
