甲状腺激素对于早期诊断急性重度胰腺炎临床价值  

Value of serum thyroid hormones in early diagnosis of severe acute pancreatitis

作　　者：沈飒[1] 林强[1] 赵洁[1] 吴增斌[1] 于洋[1] 杨敏[1] SHEN Sa LIN Qiang ZHAO Jie WU Zengbin YU Yang YANG Min(Department of Emergency, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, Chin)

机构地区：[1]上海交通大学医学院附属新华医院急救中心,上海200092

出　　处：《山西医科大学学报》2016年第9期856-859,共4页Journal of Shanxi Medical University

摘　　要：目的探讨甲状腺激素对胰腺炎疾病严重程度早期评判的价值。方法回顾收集112例急性胰腺炎患者的临床资料,疾病严重程度根据2013年亚特兰大标准分为31例重度和81例轻中度急性胰腺炎。检测入院时患者的甲状腺激素水平(FT3、FT4、TT3、TT4、TSH、r T3),进行APACHEⅡ评分及Balthazar CT分级,分析甲状腺激素水平与APACHEⅡ评分及Balthazar CT分级等临床资料的关系,比较重度组与轻中度组指标差异,并采用受试者工作特征(ROC)曲线评价各指标预测疾病严重程度是否有意义。结果重度组血清FT3,TT3和TT4水平明显低于轻中度组(P<0.05);而FT4和TSH水平组间差异无统计学意义(P>0.05)。TT3,FT3,Balthazar CT分级,FT4,r T3,APACHEⅡ评分ROC曲线下面积(AUC)依次为0.687,0.682,0.672,0.655,0.625,0.566。结论血清甲状腺激素水平可以作为早期评判急性胰腺炎严重程度的辅助指标。Objective To explore the value of serum thyroid hormones in early assessing the severity of acute pancreatitis. Methods One hundred and twelve patients with acute pancreatitis were included in this retrospective study. Patients were classified as severe（ n =31）,mild-moderate acute pancreatitis（ n = 81） according to the 2012 Atlanta revised criteria. Serum levels of thyroid hormones,including FT4,FT3,TT3,TT4,r T3 and TSH,were measured and compared at admission between two groups. The relationship between thyroid hormone level and APACHE Ⅱ score and Balthazar CT grading was analyzed. Effectiveness of thyroid hormone for the prediction of disease severity was evaluated by receiver operating characteristic（ ROC） curve analysis. Results Serum FT3,TT3 and TT4 levels in severe group were significantly lower than those in mild-moderate group（ P〈0. 05）,while serum FT4 and TSH levels showed no significant difference between the two groups（ P〈0. 05）. The area of ROC（ AUC） was 0. 687 for TT3,0. 682 for FT3,0. 672 for Balthazar CT grading,0. 655 for FT4,0. 625 for r T3,and 0. 566 for APACHEⅡ score. Conclusion The serum levels of thyroid hormone can be used as assisted markers to identify the severity of acute pancreatitis.

关 键 词：急性胰腺炎 甲状腺激素 诊断 

分 类 号：R657.51[医药卫生—外科学]