危重病儿甲状腺激素T_3、rT_3变化的临床意义  

Change of triiodothyronine and reverse triiodothyronine in the infants with dangerous and serious diseases

作　　者：杨仁仪[1] 许峰[1] 匡凤梧 王兴勇 

机构地区：[1]重庆医科大学儿童医院

出　　处：《实用儿科临床杂志》1996年第2期65-67,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨危重病患儿甲状腺激素的变化及其临床意义。方法危重症患儿共４５例，包括重症肺炎、病毒性脑炎、格林巴利综合征，颅内出血、病毒性心肌炎、食物中毒等。２０例健康儿童为对照组。用美国ＰＡＣＫＡＲＤ公司生产的γ免疫自动计数器测定危重病儿和健康儿童血中Ｔ３及ｒＴ３含量。结果２０例健康儿童和４５例危重病患儿血中Ｔ３分别为（２．８８±０．５２）ｎｍｏｌ／Ｌ和（１．４０±０．７１）ｎｍｏｌ／Ｌ（ｔ＝１３．９８，Ｐ＜０．０１），ｒＴ３分别（为０．７２±０．０８）ｎｍｏｌ／Ｌ和（１．１９±０．７３）ｎｍｏｌ／Ｌ（ｔ＝４．３６，Ｐ＜０．０１），Ｔ３／ｒＴ３分别为２．７４±０．８５和１．６１±０．７９（ｔ＝６．３８，Ｐ＜０．０１）．４例临终状态病儿Ｔ３和ｒＴ３均值分别为０．８６和１．４８ｎｍｏｌ／Ｌ，Ｔ３／ｒＴ３为０．６３。４５例患儿，治愈３７例，好转４例，死亡４例。结论危重病患儿血中Ｔ３、ｒＴ３及Ｔ３／ｒＴ３均显著低于健康儿童．４例临终状态病儿血中Ｔ３、ｒＴ３及Ｔ３／ｒＴ３更低。提示甲状腺激素降低的程度与病情严重程度呈正相关。Objectives To research the changes and clinical significance of triiodothyronine(T3) and reverse T3(rT3) in the infants with dangerous and serious diseases.Methods There were 45 infants with dangerous and serious diseases, including severe pneumonia,viralencephalitis, Guillain-Barre syndrome, intracranial hemorrhage, viral myocarditis and food poisoning.There were 20 healthy children in control group. The serum T3 and rT3 of infants with dangerous and serious diseased and healthy children were determined by immunological automatic counting produced by American Company of Packard.Results The levels of serum T3 of the 20 healthy children and 45 infants with dangerous and seriousdiseases are 2.88 ±0.52 nmol/L and 1.40 ± 0.71 nmol/L respectively (P<0.01), the levels of rT3 of them are 0.72±0.08 nmol/L and 1.19 ±0.73 nmol/L respectively (p<0.01),the Values of T3/rT3 are 2.74±0.85 and 1.61±0.79 (p<0.01). The T3 and rT3 levels in 4 infants with terminal stage are 0.86and 1.48 nmol/L respectively,the value of T3/rT3 of them is 0.63. There are 37 cases of cure, 4 casesof improvement and 4 cases of death,in the 45 cases of dangerous and serious diseases.Conclusions The levels of serum T3 and the values of T3/rT3 of infants with dangerous and serious diseaes are obviously lower and the rT3 levels of them are higher than that of healthy children. That of 4infants with terminal stage are the lowest. It's suggested that the decreased degree of T3 and rT3 should have a positive correlation with the serious degree of stage of illness.

关 键 词：危重病儿 临终状态 儿科 T3rT3 

分 类 号：R720.597[医药卫生—急诊医学]