老年患者正常甲状腺功能病态综合征与甲状腺功能减退的临床特点比较  

Comparison of clinical characteristics between euthyroid sick syndrome and hypothyroidism in elderly patients

作　　者：杨丹英[1] 赵咏桔[2] 王燕[1,3] Yang Danying;Zhao Yongju;Wang Yan(Department of General Practice,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai,200092,P.R.China;Department of Geriatrics,Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai,200025,P.R.China;Institute of Hospital Development Strategy,Chinese Academy of Hospital Development,Shanghai Jiaotong University,Shanghai,200092,P.R.China)

机构地区：[1]上海交通大学医学院附属新华医院全科医学科,上海200092 [2]上海交通大学医学院附属瑞金医院老年病科,上海200025 [3]上海交通大学中国医院发展研究院医院发展战略研究所,上海200092

出　　处：《老年医学与保健》2022年第2期335-338,348,共5页Geriatrics & Health Care

基　　金：上海交通大学中国医院发展研究院医院发展战略研究所项目(HDSI-2021-B-001)。

摘　　要：目的研究老年患者的正常甲状腺功能病态综合征(ESS)和甲状腺功能减退(甲减)的发生率及临床特点。方法2017年6月—2019年12月,纳入于上海交通大学医学院附属新华医院行血清甲状腺功能测定的894例老年患者。分析ESS和甲减的发生率,将患者分为ESS组(n=152)和甲减组(n=60)。比较2组患者在既往病史、甲状腺功能及临床生化指标方面的差异。结果894例老年患者中,ESS和甲减的发生率分别为17.00%(152/894)和6.71%(60/894)。甲减组高脂血症(x^(2)=14.735,P<0.001)和脂肪肝(x^(2)=7.946,P=0.005)患者数多于ESS组。与甲减组比较,ESS组血清总三碘甲腺原氨酸、游离三碘甲腺原氨酸、促甲状腺素、前白蛋白、白蛋白、三酰甘油、总胆固醇和低密度脂蛋白降低(P<0.05),反三碘甲状腺原氨酸升高(P<0.001)。结论老年患者ESS与甲减发生率较高,甲状腺功能、相关病史和生化指标可能有助于鉴别诊断。Objective To investigate the prevalence and clinical characteristics of euthyroid sick syndrome(ESS)and hypothyroidism in elderly patients.Methods From June 2017 to December 2019,894 elderly patients who underwent serum thyroid function examination in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University were included.The incidences of ESS and hypothyroidism among them were analyzed.The patients were divided into ESS group(n=152)and hypothyroidism group(n=60).The differences in past medical history,thyroid function and clinical biochemical indexes were compared between the two groups.Results Among 894 elderly patients,the incidences of ESS and hypothyroidism were 17.00%(152/894)and 6.71%(60/894),respectively.The number of patients with hyperlipidemia(x^(2)=14.735,P<0.001)and fatty liver(x^(2)=7.946,P=0.005)in hypothyroidism group was more than that in ESS group.Compared with the hypothyroidism group,the serum total triiodothyronine,free triiodothyronine,thyrotropin,prealbumin,albumin,triacylglycerol,total cholesterol and low density lipoprotein decreased in the ESS group(P<0.05),while reverse triiodothyronine increased(P<0.001).Conclusion The incidence of ESS and hypothyroidism in elderly patients is high.Thyroid function,related medical history and biochemical indexes may contribute to their differential diagnosis.

关 键 词：老年 正常甲状腺功能病态综合征 甲状腺功能减退 临床特点 

分 类 号：R581.2[医药卫生—内分泌]