Effect of low dose thyroxine on hemodynamics and inflammatory cytokines in patients with severe pneumonia septic shock complicated with low T3 syndrome
SHU Jiaojie1 LIU Sibo1 LIU Guoliang1 ZHOU Hengjie1 GE Dong1 GUO Yumei2▲
1.First Department of Critical Care Medicine, Dalian Municipal Central Hospital, Liaoning Province, Dalian 116033, China;
2.Three Ward of Critical Care Medicine, Dalian Municipal Central Hospital, Liaoning Province, Dalian 116033, China
Abstract：Objective To investigate the effects of low dose thyroxine on hemodynamics and inflammatory factors in patients with severe pneumonia (SP) septic shock (IS) complicated with low T3 syndrome (LT3S). Methods A total of 99 patients with SP and IS combined with LT3S who were treated in Dalian Municipal Central Hospital from September 2016 to May 2018 were selected for the study. According to the random number table method, the patients were divided into two groups, 49 cases in the observation group and 50 cases in the control group. The control group was treated with conventional cluster therapy, and the observation group was given a small dose of levothyroxine Tablets on the basis of the treatment of the control group, and the treatment lasted for 7 days. The patients were followed up for 28 days, and the survival prognosis and drug safety of the two groups were compared. Thyroid hormones, hemodynamic indicators, lung function and inflammatory factors before and after treatment were compared. Results The survival rate in the observation group was higher than that in the control group, and the mortality was lower than that in the control group (P ＜ 0.05). After treatment, triiodothyronine (T3), tyroxine (T4) and free thriiodothyronine (FT3) levels in the observation group were higher than those in the control group, and thyroid stimulating hormone (TSH) level was lower than that in the control group (P ＜ 0.05). The whole body vascular resistance index (SVRI), mean arterial pressure (MAP) and central venous pressure (CVP) in the observation group were higher than those in the control group, while the pulmonary vascular resistance index (PVRI), left ventricular work (LCW), right ventricular work (RCW), cardiac index (CI) and stroke index (SI) in the observation group were lower than those in the control group (P ＜ 0.05). There was no significant difference in lung function between the two groups (P ＞ 0.05), while the levels of TNF-α and IL-6 in the observation group were lower than those in the control group (P ＜ 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion The treatment of SP and IS combined with LT3S with low dose thyroxine can better improve the prognosis of patients, and has obvious improvement effect on thyroid hormones, hemodynamics and inflammatory factors. The drug IS safe and worthy of promotion.
舒姣洁1 刘思伯1 刘国梁1 周恒杰1 葛冬1 郭玉梅2▲. 小剂量甲状腺素对重症肺炎感染性休克合并低T3综合征患者血流动力学及炎性因子的影响[J]. 中国医药导报, 2019, 16(5): 134-137,150.
SHU Jiaojie1 LIU Sibo1 LIU Guoliang1 ZHOU Hengjie1 GE Dong1 GUO Yumei2▲. Effect of low dose thyroxine on hemodynamics and inflammatory cytokines in patients with severe pneumonia septic shock complicated with low T3 syndrome. 中国医药导报, 2019, 16(5): 134-137,150.
2019, Vol. 16 
京公网安备 11010502046598号