Predictive value of plasma baseline thyrotropin levels in nonthyroid illness syndrome patients with mechanical ventilation
LIU Ping1 ZANG Xuefeng1 ZHEN Jie1 ZHU Xi2 CHEN Wei1▲
1.Department of Critical Care, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China;
2.Department of Critical Care, the Third Hospital of Peking University, Peking 100191, China
Abstract：Objective To analyze predictive value of plasma baseline thyrotropin levels in nonthyroid illness syndrome (NTIS) patients with mechanical ventilation during hospitalization. Methods From January 2015 to August 2016, 188 patients received incubation and had no history of thyroid illness in ICU of Beijing Shijitan Hospital were continuously enrolled. All patients were divided into NTIS group of 156 cases and without NTIS group of 32 cases according to thyroid function. The morbidity and clinical characters of NTIS patients were summarized. 156 patients with NTIS were divided into two subgroups of low T3 syndrome and low T4 syndrome according to T3 and T4 levels. 156 patients with NTIS were divided into three subgroups of ＜0.27 mIU/L, 0.27-＜2.50 mIU/L, 2.50-＜4.50 mIU/L according to TSH level. Clinical data and prognosis of each group were compared. Results The morbidity of NTIS was 83%. The levels of PCT and CRP in NTIS group were higher than those in without NTIS group, while the levels of ALB and Ca2+ were lower than those in without NTIS group (P < 0.05). The levels of ALB, Ca2+ and Hb in low T4 syndrome group were lower than those in low T3 syndrome group (P < 0.05). TSH 2.50-<4.50 mIU/L group had the lowest T3 level, TSH 0.27-<2.50 mIU/L group had the shortest mechanical ventilation time (P < 0.05). COX survival analysis showed that TSH 2.50-<4.50 mIU/L was an independent predictor of good prognosis for 14 days (P ＜ 0.05). There was no significant difference in prognosis between different levels of TSH group (P > 0.05). Conclusion For patients with mechanical ventilation with NTIS, TSH 2.50-<4.50 mIU/L is an independent predictor of good prognosis for 14 days.
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2017, Vol. 14 
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