老年住院患者正常甲状腺功能病态综合征的发生率及临床特点  

Prevalence and clinical character of euthyroid sick syndrome in elderly inpatients

作　　者：杨丹英[1] 赵咏桔[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年科,200025

出　　处：《中华老年医学杂志》2010年第4期271-275,共5页Chinese Journal of Geriatrics

摘　　要：目的对正常甲状腺功能病态综合征（ESS）在老年住院患者中的发生率、病因和临床特点进行分析，并探讨ESS与病死率的关系。方法收集2006-2008年我院老年病科病房进行血清甲状腺功能测定的老年患者735例，采集一般临床资料、既往病史、血甲状腺功能测定结果及其他生化检查数据。了解并分析ESS在老年住院患者中的发生率、病因及病死率；比较ESS与甲状腺功能正常对照组在既往病史、甲状腺激素水平及生化指标方面的差异。结果本组735例患者中，共检出ESS患者160例（21．8％）。病因为多种急慢性疾病，其中以呼吸道及泌尿道感染者所占比例最高43例（26．9％）。ESS组与对照组比较，血红蛋白[（120±20）g／L对（134±16）g／L，P=0．O003、白蛋白（（33．2±5．3）g／L对（36．6±4．3）g／L，P=0．000]、总胆固醇[（4．04±1．15）mmol／L对（4．28±0．80）mmol／L，P=0．O003及低密度脂蛋白胆固醇[（2．24±0．89）mmol／L对（2．49±0．63）mmol／L，P=0．O003显著降低，差异均有统计学意义；血肌酐高于对照组[（113．61±62．91）μmol／L对（93．36±21．47）μmol／L，P=0．O00]。ESS与患者病死率显著相关（P=0．000）。结论老年住院患者ESS的发生率高，ESS常反映患者病情较重，并预示不良预后。Objective To assess the prevalence, etiology and clinical character of euthyroid sick syndrome （ESS） in elderly inpatients, and to study the relationship between ESS and mortality. Methods A total of 735 patients （638 male） aged 60-98 years in our geriatric department from 2006 to 2008 were enrolled, and the clinical data, past history, results of thyroid function test and other routine biochemical tests were collected. Thyroid function was assessed by measuring serum concentrations of thyrotropin （TSH）, thyroxine （T4） and triiodothyronine （T3）. The prevalence and mortality of ESS in these patients were evaluated, and the differences between ESS and control group were observed. Results Of 735 patients, there were 160 （21.8o//00） patients with ESS. ESS could be caused by several systemic illnesses. The prevalence of ESS was more in acute illness than in chronic illness. The hemoglobin [（120± 20） g/L vs. （134±16） g/L, P： 0. 000], serum albumin [（33.2±5.3） g/L vs. （36.6±4.3） g/L, P=0. 0003, total cholesterol [（4.04±1.15） mmol/L vs. （4.28±0.80） retool/L, P=0. 000] and low density lipoprotein [（2.24±0.89） mmol/L vs. （2.49± 0.63） mmol/L, P=0. 000] were significantly lower in ESS group than in control group. While serum creatinine [（113. 61±62. 91） μmol/L vs. （93.36±21.47） μmol/L, P=0.000] was higher in ESS group than in control group. The presence of ESS was positively associated with mortality （P=0. 000）. Conclusions The prevalence of ESS is high in elder patients, and ESS is associated with serious illness and poor prognosis.

关 键 词：功能正常甲状腺病综合征 住院患者 

分 类 号：R581.9[医药卫生—内分泌]