脓毒症患者血清甲状腺激素、降钙素原变化的临床研究  

A clinic study on the changes of thyroxine and procalcitonin of sepsis patients

作　　者：曹黛茵 王丽纯[1] 陈雷[1] 胡文利[1] 寇秋野[1] 

机构地区：[1]中山大学附属第六医院ICU,广州510655

出　　处：《中华临床医师杂志（电子版）》2015年第23期64-67,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的通过观察脓毒症患者甲状腺激素及血清降钙素原(PCT)水平变化,探讨非甲状腺病态综合征(NTIS)与感染严重程度及预后的关系。方法测定74例确诊为细菌感染的脓毒症患者PCT水平,分为脓毒症组(n=48)及重度脓毒症组(n=26),测定促甲状腺激素(TSH)、血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)含量;随访28 d,根据28 d病死率分为死亡组(n=34)及存活组(n=40),比较两组组内指标的差异。结果重度脓毒症组FT3及TSH明显低于脓毒症组(t值分别为-10.580及-3.577,均P<0.05),FT4在两组间无统计学差异;死亡组PCT明显高于存活组(t=5.690,P<0.05),FT3、TSH显著低于存活组(P<0.05),FT4在两组间无统计学差异;血清PCT与FT3呈显著负相关(r=-0.834,P<0.01),TSH、FT4与PCT无明显相关性(P>0.05),结论甲状腺激素与PCT及感染疾病的严重程度具有相关性,对判断疾病预后具有一定的价值。Objective By observing the levels of thyroxine and serum procalcitonin(PCT) in patients with sepsis, to explore the relationship between nonthyroidal illness syndrome(NTIS) and infection degree, prognosis of disease. Methods Seventy-four sepsis patients diagnosed with bacterial infection were divided into sepsis group(48 cases) and severe sepsis group(26 cases), serum level of PCT, TSH, FT3, FT4 were examined, and patients were followed up for 28 days, and then were divided into death group(34 cases) and survival group(40 cases), the index between two groups were compared. Results Serum levels of FT3 and TSH were significantly lower in the severe sepsis group than that in sepsis group(P<0.05), there was no difference in FT4. Serum levels of PCT was higher in death group than that in survival group(P<0.05), while the levels of FT3 and TSH were lower than that in survival group(P<0.05), there was no changes in FT4. Serum level of FT3 was negatively correlated with PCT(r=-0.834, P<0.01). There were no significant correlation between levels of TSH, FT4 and PCT(P>0.05). Conclusion Serum level of thyroxin is correlated with PCT and infection disease severity, and it has some value in predicting prognosis of disease.

关 键 词：脓毒症 降钙素原 甲状腺激素 

分 类 号：R459.7[医药卫生—急诊医学]