老年脓毒症患者血清甲状腺激素水平与营养状况的相关性研究  

Correlation between serum thyroid hormone levels and nutritional status in elderly septic patients

作　　者：韩佩佩 马晓薇 轩蕊蕊 HAN Peipei;MA Xiaowei;XUAN Ruirui(Department of Intensive Care Medicine,Cardio-Cerebrovascular Hospital,General Hospital of Ningxia Medical University,Yinchuan 75002,China)

机构地区：[1]宁夏医科大学总医院心脑血管病医院重症医学科,宁夏银川750002

出　　处：《宁夏医学杂志》2025年第1期16-19,共4页Ningxia Medical Journal

基　　金：宁夏重点研发计划项目(2022BEG02045)。

摘　　要：目的探讨老年脓毒症患者的血清甲状腺激素水平与其营养状况的关系。方法选取104例脓毒血症/脓毒性休克患者作为研究对象。根据改良版危重症营养风险(mNUTRIC)评分,将研究对象分为营养低风险组(mNUTRIC<5分)57例、营养高风险组(mNUTRIC≥5分)47例,收集纳入研究的患者一般资料、身体质量指数(BMI)、白蛋白(ALB)水平、总蛋白(TP)水平、甲状腺功能指标、序贯器官衰竭(SOFA)评分、急性生理和慢性健康(APACHEⅡ)评分等临床资料,并进行统计分析。结果营养低风险组及营养高风险组患者糖尿病、高血压、冠心病发病率比较差异无统计学意义(P>0.05)。2组患者年龄、性别、BMI比较差异无统计学意义(P>0.05)。营养低风险组患者ALB、TP水平显著高于营养高风险组(P<0.05)。营养低风险组患者TT_(3)、TT_(4)水平显著高于高风险组(P<0.05),2组患者FT_(3)、FT_(4)、TSH水平比较差异无统计学意义(P>0.05)。相关性分析发现,mNUTRIC评分与ALB、TP、TT_(4)、TT_(3)水平呈负相关(P<0.05)。结论老年脓毒症患者的血清ALB、TP、TT_(3)、TT_(4)水平降低,患者的营养风险升高,提示老年脓毒症患者的甲状腺功能、ALB、TP与其营养状况可能存在一定相关性。Objective To investigate the relationship between serum thyroid hormone levels and nutritional status in elderly patients with sepsis.Methods 104 patients with sepsis/septic shock were selected for the study.According to the modified Nutrition Risk in the Critically ill(mNUTRIC)score,the patients were divided into nutritional low-risk group(mNUTRIC<5 points,n=57),nutritional high-risk group(mNUTRIC≥5 points,n=47).And the clinical data,BMI,ALB,TP,thyroid function indexes,SOFA score,APACHEⅡscore and other clinical data were statistically analyzed.Results The incidence of diabetes mellitus,hypertension,and coronary heart disease was higher in the nutritional low-risk group and nutritional high-risk group,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in age,gender,and BMI between the two groups(P>0.05).The levels of ALB and TP were significantly higher in the nutritional low-risk group than in the nutritional high-risk group(P<0.05),the levels of TT_(3) and TT_(4) were significantly higher in the nutritional low-risk group than in the nutritional high-risk group(P<0.05),and the differences between the two groups were not statistically significant for FT_(3),FT_(4) and TSH(P>0.05).Correlation analysis revealed that mNUTRIC score was negatively correlated with ALB,TP,TT_(4) and TT_(3)(P<0.05).Conclusion Serum ALB,TP,TT_(3),and TT_(4) levels are decreased in elderly sepsis patients,and the nutritional risk of patients is increased,suggesting that there may be a correlation between thyroid function,ALB,and TP in elderly sepsis patients and their nutritional status.

关 键 词：老年 脓毒症 营养状况 甲状腺激素 

分 类 号：R459.7[医药卫生—急诊医学]