老年住院患者反三碘甲腺原氨酸水平与病情及预后的相关性研究  

Association of rT_3 level with the severity and prognosis of elderly hospitalized patients

作　　者：耿直[1] 乐忠宏[1] 崔婷婷[1] 薛焕霞[1] 王晓春[1] 汤小姣[1] 张洁[1] 

机构地区：[1]焦作市人民医院老年病科,河南焦作454002

出　　处：《中国医学前沿杂志（电子版）》2016年第4期107-111,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析老年住院患者反三碘甲腺原氨酸(reverse triiodothyronine,rT_2)水平与病情及预后的相关性,为老年住院患者预后的早期评估提供参考指标。方法选取本院2012年5月至2015年5月收治的304例老年住院患者为研究对象,分别检测患者血清甲状腺激素、清蛋白、胆固醇水平,并按照rT_3水平进行分组,比较不同rT_3水平,不同清蛋白、胆固醇水平患者一般资料、死亡率、病情、血清学指标差异,分析rT_3水平与患者病情及预后的相关性。结果304例老年住院患者中,甲状腺功能异常137例(45.07%)。rT_3水平升高87例(28.62%),其余217例(7I.38&%名)患者rT_3水平正常。rT_3水平升高组与rT_3水平正常组患者年龄、性别比例比较差异均无显著性(P>0.05),rT_3水平升高组患者死亡率、急性重症疾病构成比均显著高于rT_3水平正常组,血清清蛋白、胆固醇、游离三碘甲腺原氨酸(FT_3)水平均显著低于rT_3水平正常组(P<0.05)。随着rT_3水平升高程度的增加,患者死亡率显著上升(P<0.05),Pearson相关分析示,rT_3水平与患者死亡率变化呈显著正相关(r=0.719,P<0.05)。低清蛋白、胆固醇水平患者游离甲状腺素(FT_4)、FT_3水平均显著低于高清蛋白、胆固醇水平患者,rT_3水平显著高于高清蛋白、胆固醇水平患者(P<0.05):不同清蛋白、胆固醇表达水平患者血清促甲状腺激素(TSH)水平比较差异具有显著性(P>0.05)。结论血清rT_3水平升高提示老年住院患者营养状态差、病情危重、死亡率较高,应加强对老年住院患者rT_3水平的定期监测,为制订治疗方案与评估预后提供参考。Objective To analyze the correlation of reverse triiodothyronine（rT3） level and the severity and prognosis of elderly hospitalized patients,so as to provide laboratorg indexes to evaluate the prognosis of elderly hospitalized patients.Method 304 cases of elderly hospitalized patients in our hospital from May 2012 to May 2015 were chosed as the research objects,detected the levels of the serum thyroid hormones,albumin,cholesterol and in accordance with the rT3 levels in patients with were grouped comparison of different rT3levels,different albumin,cholesterol levels in patients with general information,mortality,disease,serological indexes differences.Analysed correlation of rT3 level and the severity and prognosis of patients.Result Among304 elderly hospitalized patients,146 cases（48,03%） of abnormal thyroid function;in 87 cases,rT3 increased28.62%,the remaining 217 cases of patients with normal rT3,accounting for 71.38%.Elevated rT3 group and rT3normal group patients age,sex ratio,the difference were not statistically significant（P 0.05）,rT3 increased the mortality rate of the group,severe acute disease constitute ratio was significantly higher than normal rT3 group,the serum albumin,cholesterol,rT3 were significantly lower than that of the latter（P 0.05）.With the increase of the level of rT3 increased,the mortality rate increased significantly（P 0.05）.Low levels of albumin,cholesterol,FT4,FT3 were significantly lower than that in the high level of albumin,cholesterol,the rT3 was significantly higher than that of the latter（P 0.05）,albumin,cholesterol expression of serum TSH in patients,the difference were not statistically significant（P 0.05）.Conclusion The elevation of conclusion serum rT3,indicates that the elderly hospitalized patients with poor nutritional status,illness and high mortality rate,should strengthen regular monitoring of rT3 levels in elderly hospitalized patients with regular monitoring,provide a reference for the regimen in the treatment of development and prognosi

关 键 词：老年 住院患者 反三碘甲腺原氨酸 预后 相关性 

分 类 号：R581[医药卫生—内分泌]