摘要
目的探讨伴低三碘甲状腺原氨酸(T3)综合征对重症新型冠状病毒肺炎(新冠肺炎)患者预后的影响。方法回顾性分析2020年2月10日—3月31日武汉同济医院光谷院区住院的117例重症新冠肺炎患者的临床及实验室资料。根据入院时血清游离T3(FT3)水平将入选者分为低T3组(FT3<3.1 pmol/L)和正常T3组(FT3≥3.1 pmol/L),收集两组患者的基本资料、临床症状、合并症和实验室检查情况,分析两组间各项指标的差异。通过Logistic回归分析分析重症新冠肺炎患者死亡的危险因素。结果与正常T3组患者相比,低T3组患者入院前病程更长、氧合指数更低(z=-2.028、-2.125,P<0.05);低T3组患者白蛋白、淋巴细胞计数、淋巴细胞比率更低,肌钙蛋白I、N末端脑钠肽前体、降钙素原、D二聚体、白细胞介素2、白细胞介素6及肿瘤坏死因子α水平更高(z=-2.915^-2.055,P<0.05)。多因素Logistic回归分析显示,入院时氧合指数<40 kPa(OR=5.562,95%CI=1.170~32.911,P<0.05)及血清FT3<3.1 pmol/L(OR=4.711,95%CI=2.130~21.827,P<0.05)是重症新冠肺炎患者死亡的独立危险因素。结论合并低T3综合征可能增加重症新冠肺炎患者的死亡风险。
Objective To investigate the impact of low T3 syndrome on the prognosis of patients with severe coronavirus disease 2019(COVID-19).Methods A retrospective analysis was performed for the clinical and laboratory data of 117 patients with severe COVID-19 who were hospitalized in Guanggu Branch of Wuhan Tongji Hospital from February 10,to March 31,2020.According to the serum level of free triiodothyronine(FT3)on admission,the patients were divided into low T3 group(FT3<3.1 pmol/L)and normal T3 group(FT3≥3.1 pmol/L),and general information,clinical symptoms,complications,and laboratory examinations were collected and compared between the two groups.A Logistic regression analysis was used to investigate the risk factors for death in patients with severe COVID-19.Results Compared with the normal T3 group,the low T3 group had a significantly longer course of disease before admission and a significantly lower oxygenation index(z=-2.028,-2.125,P<0.05),as well as significantly lower albumin,lymphocyte count,and lymphocyte ratio and significantly higher levels of troponin I,N-terminal pro-brain natriuretic peptide,procalcitonin,D-dimer,interleukin-2,interleukin-6,and tumor necrosis factorα(z=-2.915--2.055,P<0.05).The multivariate logistic regression analysis showed that oxygenation index<40 kPa on admission(OR=5.562,95%CI=1.170-32.911,P<0.05)and serum FT3 level<3.1 pmol/L(OR=4.711,95%CI=2.130-21.827,P<0.05)were independent risk factors for death in patients with severe COVID-19.Conclusion Low T3 syndrome may increase the risk of death in patients with severe COVID-19.
作者
郭永芳
刘卫国
李堃
王诗博
梁坤
张继东
GUO Yongfang;LIU Weiguo;LI Kun;WANG Shibo;LIANG Kun;ZHANG Jidong(Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)
出处
《精准医学杂志》
2020年第5期453-457,共5页
Journal of Precision Medicine
基金
青岛大学附属医院临床医学+X项目。
