重症脑梗死肺部感染患者血清甲状腺激素与炎性指标的变化研究  

Changes of serum thyroid hormones and inflammatory markers in patients with severe cerebral infarction and pulmonary infection

作　　者：陈黔妹[1] 刘芳[1] 石劲松[1] 董文翊[1] 向雅娟 刘佳琪 CHEN Qian-mei;LIU Fang;SHI Jin-song;DONG Wcn-yi;XIANG Ya-juan;LIU Jia-qi(First Affiliated Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院神经内科

出　　处：《中华医院感染学杂志》2019年第23期3577-3580,3585,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年基金项目(81801052)

摘　　要：目的探索重症脑梗死肺部感染患者血清甲状腺激素与炎性因子的改变情况。方法选取2015年5月-2018年5月于清华大学第一附属医院接受治疗的124例重症脑梗死肺部感染患者为研究对象并作为试验组,另外随机选取同期于医院接受体检的124名健康体检者作为对照组。采用电话随访的方式对试验组患者进行预后情况调查,并按照随访结果将试验组患者分为生存组和死亡组,对比各组患者血清甲状腺激素变化情况和炎性因子变化情况。结果试验组游离三碘甲状腺原氨酸(Free triiodothyronine-3,FT3)、三碘甲状腺原氨酸(Triiodothyronine,T3)、甲状腺素(Thyroxine,T4)指标水平分别为(3.10±0.28)pmol/L、(1.33±0.14)nmol/L、(104.29±30.57)nmol/L,均低于对照组,试验组促甲状腺激素(Thyroid stimulating hormone,TSH)指标水平(4.32±2.45)μU/ml高于对照组,差异均具有统计学意义(P<0.05)。试验组C-反应蛋白(C-reactive protein,CRP)、糖分解烯醇酶(National Stock Exchange,NSE)、纤维蛋白原(Fibrinogen,FIB)、谷丙转氨酶(Alanine transaminase,ALT)指标水平高于对照组,差异均具有统计学意义(P<0.05)。生存组FT3、T3、T4指标水平高于死亡组,生存组TSH指标水平低于死亡组,差异均具有统计学意义(P<0.05)。死亡组CRP、NSE、FIB、ALT指标水平高于生存组,差异均具有统计学意义(P<0.05)。结论重症脑梗死肺部感染患者血清甲状腺激素含量水平下降明显,血清炎性因子显著升高,随访期间重症脑梗死肺部感染死亡患者血清甲状腺激素及炎性因子水平变化更显著,患者相关指标变化与病情严重程度及临床疗效的关系有待进一步研究。OBJECTIVE To explore the changes of serum thyroid hormones and inflammatory factors in patients with severe cerebral infarction and pulmonary infection.METHODS Totally 124 patients with severe cerebral infarction and pulmonary infection who were treated at the First Affiliated Hospital of Tsinghua University from May 2015 to May 2018 were selected as the experimental group.A total of 124 healthy people undergoing medical examinations at the same time were included as the control group.The prognosis of the patients in the experimental group was calculated by telephone follow-up.According to the follow-up results,the patients in the experimental group were divided into the survival group and the death group.The changes of serum thyroid hormone and the changes of inflammatory factors in different groups were compared.RESULTS The levels of free triiodothyronine-3(FT3),triiodothyronine(T3)and thyroxine(T4)in the experimental group were(3.10±0.28)pmol/L,(1.33±0.14)nmol/L and(104.29±30.57)nmol/L,significantly lower than those in the control group.The level of thyroid stimulating hormone(TSH)was(4.32±2.45)μU/ml,significantly higher than that of the control group(P<0.05).The levels of C-reactive protein(CRP),saccharolytic enolase National Stock Exchange(NSE),fibrinogen(FIB)and alanine transaminase(ALT)were all significantly higher than those of the control group(P<0.05).The FT3,T3,and T4 levels in the survival group were significantly higher than those in the death group.The TSH level in the survival group was significantly lower than that in the death group(P<0.05).The levels of CRP,NSE,FIB and ALT in the death group were significantly higher than those in the survival group(P<0.05).CONCLUSION The levels of serum thyroid hormones and inflammatory factors in patients with pulmonary infection after severe cerebral infarction decreased significantly,and serum inflammatory factors increased significantly.During the follow-up period,the levels of serum thyroid hormones and inflammatory factors in patients with pulmonary

关 键 词：脑梗死 重症肺部感染 甲状腺激素 炎性因子 

分 类 号：R563.1[医药卫生—呼吸系统]