非甲状腺疾病综合征机械通气患者血浆基线促甲状腺激素水平对预后的预测价值

Abstract
Figure/Table
References (20)
Related Citation (15)

Download: PDF (442 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

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.

Key words： Mechanical ventilation Nonthyroid illness syndrome Thyroid stimulating hormone Prognosis

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIU Ping1 ZANG Xuefeng1 ZHEN Jie1 ZHU Xi2 CHEN Wei1▲

Cite this article:

LIU Ping1 ZANG Xuefeng1 ZHEN Jie1 ZHU Xi2 CHEN Wei1▲. Predictive value of plasma baseline thyrotropin levels in nonthyroid illness syndrome patients with mechanical ventilation[J]. 中国医药导报, 2017, 14(18): 68-71,75.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I18/68

[1] Ibrahim C，Tolga U，Sertac H. Prolonged mechanical ventilation associated with hypothyroidism after paediatric cardiac surgery [J]. Cardiol Young，2014，24（4）：745-747.
[2] Liu J，Wu X，Lu F，et al. Low T3 syndrome is a strong predictor of poor outcomes in patients with community-acquired pneumonia [J]. Sci Rep，2016，6：22271.
[3] De Alfieri W，Nisticò F，Borgogni T，et al. Thyroid hormones as predictors of short-and long-term mortality in very old hospitalized patients [J]. J Gerontol A Biol Sci Med Sci，2013，68（9）：1122-1128.
[4] Tognini S，Marchini F，Dardano A，et al. Non-thyroidal illness syndrome and short-term survival in a hospitalised older population [J]. Age Ageing，2010，39（1）：46-50.
[5] Bello G，Pennisi MA，Montini L，et al. Nonthyroidal illness syndrome and prolonged mechanical ventilation in patients admitted to the ICU [J]. Chest，2009，135（6）：1448-1454.
[6] Surks MI，Ortiz E，Daniels GH，et al. Subclinical thyroid disease：scientific review and guidelines for diagnosis and management [J]. JAMA，2004，291（2）：228-238.
[7] Green KA，Werner MD，Franasiak JM，et al. Investigating the optimal preconception TSH range for patients undergoing IVF when controlling for embryo quality [J]. J Assist Reprod Genet，2015，32（10）：1469-1476.
[8] 张红霞.血清甲状腺激素检测对COPD机械通气患者的临床价值[J].西部医学，2014，26（1）：54-55.
[9] 吴苏武，张绵锋，林玉芸.非甲状腺疾病综合征与急性呼吸窘迫综合征患者预后的相关性[J].广东医学，2014，35（12）：1926-1927.
[10] 肖敏烨，尘坚，丁雯.老年肺部感染与低T3综合征的相关性[J].中国老年学杂志，2013，33（22）：5512-5513.
[11] Satti H，Mafukidze A，Jooste PL. High rate of hypothyroidism among patients treated for multidrug-resistant tuberculosis in Lesotho [J]. Int J Tuberc Lung Dis，2012，16（4）：468-472.
[12] Van den Berghe G. Non-thyroidal illness in the ICU：a syndrome with different faces [J]. Thyroid，2014，24（10）：1456-1465.
[13] Yang N，Zhang DL，Hao JY. Serum levels of thyroid hormones and thyroid stimulating hormone in patients with biliogenic and hyperlipidaemic acute pancreatitis：difference and value in predicting disease severity [J]. J Int Med Res，2016，44（2）：267-277.
[14] Iglesias P，Munoz A，Prado F，et al. Serum thyrotropin concentration is an early marker of normalization of low triiodothyronine syndrome in aged hospitalized patients after discharge [J]. J Endocrinol Invest，2010，33（9）：607-611.
[15] Ceresini G，Marina M，Lauretani F，et al. Relationship between circulating thyroid-stimulating hormone，free thyroxine，and free triiodothyronine concentrations and 9-year mortality in euthyroid elderly adults [J]. J Am Geriatr Soc，2016，64（3）：553-560.
[16] 张璇，王文尧，杨敏.心脏移植患者基础甲状腺激素水平对其预后的影响[J].中国循环杂志，2015，30（12）：1173-1177.
[17] Farwell AP. Thyroid hormone therapy is not indicated in the majority of patients with the sick euthyroid syndrome [J]. Endocr Pract，2008，14（9）：1180-1187.
[18] Liu H，Yan W，Xu G. Thyroid hormone replacement for nephrotic syndrome patients with euthyroid sick syndrome：a meta-analysis [J]. Ren Fail，2014，36（9）：1360-1365.
[19] Yang P，Li Y，Xu G. Antioxidant therapy improves non-thyroidal illness syndrome in uremic rats [J]. Ren Fail，2016，38（4）：514-520.
[20] Li R，Ren J，Wu Q. Role of enteral nutrition in nonthyroidal illness syndrome：a retrospective observational study [J]. BMC Endocr Disord，2015，15（1）：69-76.