文章摘要
赵催春1 任颖1 邵琦1 杜冬梅1 全军民1 周明2.探讨NTIS 在ICU 重症患者的预后影响[J].,2011,11(12):2269-2272
探讨NTIS 在ICU 重症患者的预后影响
Effect of Nonthyroidal Illness Syndrome on Prognosis ofCritically Ill ICU Patients
  
DOI:
中文关键词: 非甲状腺疾病综合症  重症  血清游离三碘甲状腺原氨酸
英文关键词: Nonthyroidal  Illness  Syndrome  Severe diseases
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作者单位
赵催春1 任颖1 邵琦1 杜冬梅1 全军民1 周明2 上海交通大学第六人民医院特需医疗科 
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中文摘要:
      目的:观察NTIS 在ICU 重症患者中的发病情况,及对病情的预后。方法:2010 年1 月到2010 年3 月,收集上海交通大学附 属第六人民医院重症监护病房ICU 收治的患者共161 例。根据甲状腺功能情况分组。记录其年龄、性别、血糖、血白蛋白、肝肾功 能、电解质、白细胞、血气、心率、血压等,统计有创呼吸机的使用率、使用天数、APACHEII 评分、ICU 住院天数和住院期间的死亡 率,分析相关的影响因素。结果:161 例入住ICU 的重症患者中74 例伴有NTIS(45.96%),血清游离三碘甲状腺原氨酸(FT3)水 平是ICU 住院时间的独立影响因素,低T3 与住院期间死亡率明显相关,是主要死亡危险因子;NTIS 患者较正常甲状腺患者死亡 风险增加2.93 倍(95%CI, 1.052~8.182)。结论:低T3 在重症疾病患者中发病常见,与住院期间死亡率明显相关,对于预测患者病 情的严重程度和预后有重要的价值。
英文摘要:
      Objective: To investigate the prevalence of low T3 syndrome in patients with severe disease and explore the effect T3 syndrome on outcome of the severe disease. Methods: One hundred and sixty-one patients with severe disease admitted to Intensive care unit (ICU) underwent examinations of thyroid function and were further categorized according to thyroid hormone profile. The records of the ventilation utilization, the days of utilization ,the length of stay in the ICU, mortality during hospitalization were evaluated, and the related factors were analysed. Result: Seventy-four of the 161patients ( 45.96% ) with low T3 syndrome. Free triiodothyronine ( FT3 ) was the independent influential factor for length of hosp ital stay. Low FT3 was significantly correlated with mortality during hospitalization. . It was revealed by multivariate Cox regression analysis that FT3 was the chief predictor for cumulative death ( risk ratio, 2.93; 95% confidential interval, 1.052 - 8.182). Conclusion: The prevalence of low T3 syndrome in patients with severe disease reach to 50%, and low T3 syndrome plays an important role in predicting the disease severity and outcome.
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