外科危重患者甲状腺激素动态监测的临床意义  

Clinical Significance of Dynamical Monitoring of Thyroid Hormone in Endangered Patients of Surgery

作　　者：吴威士[1] 张孟贤[1] 李颖[1] 李洁珍[1] 

机构地区：[1]广东省韶关市粤北人民医院加强医疗科,512026

出　　处：《中国误诊学杂志》2002年第5期695-696,共2页Chinese Journal of Misdiagnostics

摘　　要：目的　探讨外科危重患者血浆甲状腺激素 (TH)的变化及临床意义。方法　应用放射免疫法测定 36例大手术患者术后第 1天血浆 TH含量。除外术后第 2天内死亡的 4例 ,继续测定另外 32例患者术后第 3、5天的血浆 TH含量。结果　术后第 1天 T3 / FT3 含量 (T3 :0 .2 1nmol/ L± 0 .2 7nmol/ L,FT3 :1.32 pmol/ L± 0 .6 7pmol/ L)明显低于正常参考值 (T3 :1.40～ 3.40 nmol/ L ,FT3 :2 .5 0～ 9.82 pmol/ L ) ,P<0 .0 1。其中 4例死亡患者 T4和 FT4也明显降低 (T4:7.40 nmol/ L± 1.73nmol/ L ,FT4:1.11pmol/ L± 0 .16 pmol/ L ) ,与另外 32例患者比较 (T4:5 7.86 nmol/ L± 2 1.49nmol/ L,FT4:7.14pmol/ L± 3.72 pmol/ L)有显著性差异 (P<0 .0 1)。结论　外科危重患者血浆 TH水平下降 ,动态监测TH水平 。Objective To evaluate the clinical significance of changes in plasma thyroid hormone (TH) in endangered patients of surgery. Methods Plasma thyroid hormone concentrations were measured in 36 patients of large surgery in the first day by radioimmunoassay,except four patients of death in two days after surgery,continue to measure other 32 patients after surgery plasma TH concentrations in the third,fifth day.Results Plasma T 3 and FT 3 concentrtions in patients after surgery in the first day(T 3:0.21 nmol/L±0.27 nmol/L,FT 3:1.32 pmo l/L±0.67 pmol/L) were significantly lower than normal parameter (T 3:1.40～3.40 nmol/L,FT 3:2.50～9.82 pmol/L)P<0.01.Four dead patients T 4 and FT 4 also reduce apparently(T 4:7.40 nmol/L±1.73 nmol/L,FT 4:1.11 pmol/L±0.16 pmol/L),compare with other 32 patients(T 4:57.86 nmol/L±21.49 nmol/L,FT 4:7.14 pmol/L±3.72 pmol/L) have remarkable difference(P<0.01).Plasma TH reduce in critical patients of surgery,trending determination of plasma TH lever may be paramater of reference to appraise outcome of the illness.Conclusion Plasma Thyroid levels decreased after surgical operation,so dynamical monitoring of thyroid levels might serve as a index for doctors to judge the prognosis.

关 键 词：外科危重患者 甲状腺激素 放射免疫法 动态监测 危重病 预后评估 

分 类 号：R605.97[医药卫生—急诊医学]