老年重症中毒患者皮质醇和甲状腺功能的变化研究  

Study on changes of cortisol and thyroid function in elderly patients with severe poisoning

作　　者：田洪雨 王辉 徐君 李嘉运 Tian Hongyu;Wang Hui;Xu Jun;Li Jiayun(Department of Thyroid,Head and Neck Surgery,People’s Hospital of Cangzhou City,Cangzhou,Hebei,061000,P.R.China;Department of General Surgery,Shanghai Tongren Hospital,Shanghai,200336,P.R.China)

机构地区：[1]沧州市人民医院甲状腺头颈外科,河北沧州061000 [2]上海市同仁医院普外科,上海200336

出　　处：《老年医学与保健》2021年第3期609-612,共4页Geriatrics & Health Care

基　　金：沧州市重点研发计划指导项目(183302134)。

摘　　要：目的探究老年重症中毒患者皮质醇和甲状腺功能的变化,分析其与病情发展的关联性及临床意义。方法选取2016年1月-2019年12月沧州市人民医院重症监护室(ICU)收治的102例急性中毒患者为观察组,再选取同期健康体检者102例为对照组,分别采集他们的静脉血标本,检测其皮质醇(COR)、血清游离三碘甲腺原氨酸(FT3)、血清游离四碘甲腺原氨酸(FT4)与促甲状腺激素(TSH)等激素水平,并对比分析。结果观察组102例患者中,死亡29例(28.43%)、转诊25例(24.51%)、放弃2例(1.96%)、出院41例(40.20%)、好转5例(4.90%)。与对照组比较,观察组的FT3、FT4与TSH水平均明显降低,COR水平明显升高,差异有统计学意义(P<0.05)。与出院患者相比,死亡患者的FT3、FT4和TSH水平明显较低,而COR水平较之明显升高,差异有统计学意义(P<0.05)。结论老年重症中毒患者的COR水平明显升高,而FT3、FT4与TSH等甲状腺功能指标下降,分析重症中毒患者相应指标水平,对于指导临床治疗,判断重症中毒患者治疗预后有重要意义,具有一定临床参考价值。Objective To explore the changes of cortisol and thyroid function in elderly patients with severe poisoning,and analyze their correlation with the development of the disease and its clinical significance.Methods 102 patients with acute poisoning admitted to the Intensive Care Unit(ICU)of People’s Hospital of Cangzhou City from January 2016 to December2019 were selected as the observation group,and 102 healthy people during the same period were selected as the control group.Their venous blood samples were collected,and the levels of cortisol(Cor),free triiodothyronine(FT3),free tetraiodothyronine(FT4)and thyroid stimulating hormone(TSH)were detected and compared one another.Results Among the 102 patients in the observation group,29 cases died(28.43%),25 cases were referred(24.51%),2 cases gave up(1.96%),41 cases were discharged(40.20%),and 5 cases were improved(4.90%).Compared with the control group,the levels of FT3,FT4 and TSH of the observation group were significantly lower,and the level of Cor was significantly higher(P<0.05).Compared with the discharged patients,the levels of FT3,FT4 and TSH of the dead patients were significantly lower,while the level of Cor of the dead patients was significantly higher(P<0.05).Conclusion The level of Cor of the elderly patients with severe poisoning was significantly increased,while the thyroid function indexes such as FT3,FT4 and TSH decreased.Analysis of the corresponding indexes’changes of severe poisoning patients is of great significance for guiding clinical treatment and judging the prognosis of patients,which has certain clinical reference value..

关 键 词：老年 重症中毒 皮质醇 甲状腺功能 

分 类 号：R595[医药卫生—内科学]