| 脓毒症并机械通气患者的甲状腺激素水平与其预后的相关性分析 |
| 投稿时间：2016-03-08 修订日期：2016-03-24 点此下载全文 |
| 引用本文：方赛,刘婷,胡善友,姜婷婷,游达礼,王飞.脓毒症并机械通气患者的甲状腺激素水平与其预后的相关性分析[J].医学研究杂志,2016,45(10):85-88 |
| DOI：
10.11969/j.issn.1673-548X.2016.10.022 |
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| 基金项目:上海市嘉定区卫生系统第三批重点学科建设项目（ZD01）；上海市嘉定区中心医院第十一批中青年骨干培养计划项目 |
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| 中文摘要:目的 探讨脓毒症并机械通气患者的甲状腺激素水平与其预后的相关性。方法 选择连续入住上海市嘉定区中心医院急诊ICU的脓毒血症并机械通气患者50例，记录患者的一般资料、相关实验室检查、APACHE Ⅱ评分及28天的预后，根据其预后将患者分为死亡组（n=31）与存活组（n=19），比较两组患者的一般资料及实验室指标的差异；以死亡为因变量，采用逐步线性回归分析找出死亡的独立影响因素，采用Spearman相关分析对有意义的因素进行相关分析。结果 所有50例病例的总病死率为62%（31/50），甲状腺功能异常率为84%（42/50）；死亡组的APACHE Ⅱ评分[24.5（10）vs 19（7）]、血肌酐[126（214）vs 77（74.9）]显著增高，而T3[0.61（0.16）vs 0.74（0.34）]、T4[66.00（25.44）vs 87.28（26.02）]、FT4[12.32（3.94）vs 17.59（4.81）]显著降低（P均<0.05）；血管活性药物应用（偏相关系数=0.381，P=0.002）及FT4（偏相关系数=-0.413，P=0.001）与死亡呈独立线性相关。Spearman相关分析显示，FT4与APACHE Ⅱ评分呈显著负相关（r=-0.298，P=0.036）。结论 脓毒症并机械通气患者的甲状腺功能会发生明显变化，甲状腺激素水平尤其是FT4水平，对预后有重要参考价值。 |
| 中文关键词:脓毒血症 机械通气 甲状腺激素 预后 |
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| Correlation between Prognosis with Thyroid Hormone among Mechanically Ventilated Sepsis Patients |
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| Abstract:Objective To investigate the correlation between 28-day prognosis of mechanically ventilated sepsis patients with the level of thyroid hormone. Methods From July 2014 to September 2015, a total of 50 mechanically ventilated sepsis patients in our Intensive care unit (ICU) were enrolled to study. Physical data, laboratory data, APACHE Ⅱ scores and 28-day prognosis were collected. The patients were divided into survival group (n=19) and non-survival group (n=31) based on their outcomes. Differences in the data between the two groups were compared. Independent factors related deaths were found by stepwise linear regression analysis. The correlation between the significant factors were analyzed by Spearman correlation test. Results In all 50 patients, total mortality was 62% (31/50). Thyroid dysfunction rate was 84% (42/50). Compared with the survival group, APACHE Ⅱ score[24.5(10) vs 19(7)] and serum creatinine[126(214) vs 77(74.9)] were significantly increased in Non-survival group. Meanwhile, T3[0.61(0.16) vs 0.74(0.34)], T4[66.00(25.44) vs 87.28(26.02)] and FT4[12.32(3.94) vs 17.59(4.81)] significantly reduced (all P<0.05). The use of vasoactive drugs (partial correlation coefficient=0.381, P=0.002) and FT4 (partial correlation coefficient=-0.413, P=0.001) were the independent factors with death. FT4 was significantly negatively correlated with APACHE Ⅱ score (r=-0.298, P=0.036). Conclusion There is a high incidence of thyroid function abnormalities in mechanically ventilated sepsis patients. The level of FT4 has an additional predictive value for the prognosis of the patients. |
| keywords:Sepsis Mechanical ventilation Thyroid hormone Prognosis |
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