危重症患儿血清甲状腺激素谱。

Serum thyroid hormone profile in critically Ill children.

机构信息

Department of Pediatrics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India.

出版信息

Indian J Pediatr. 2009 Dec;76(12):1217-21. doi: 10.1007/s12098-009-0250-7.

DOI:10.1007/s12098-009-0250-7

PMID:19936665

Abstract

OBJECTIVE

To study thyroid hormone profile in critically ill children and its correlation to disease severity and clinical outcome.

METHODS

Total serum triiodothyronine (T3), thyroxine (T4) and TSH were estimated at admission and discharge from PICU/ just before death.

RESULTS

Mean T3 levels in cases were significantly lower than controls and lower in patients who expired, both at admission and just prior to death. Mean T4 levels were lower in cases, and just prior to death. Mean TSH levels were not different in cases and controls; or in survived and expired cases. When both T3 and T4 are low, mortality risk increases 30 times. Serum T3, T4 and TSH values improved in patients who survived unlike in those who expired. Age, sex, duration of hospital stay, ventilation, inotropic support, and PICU stay did not show any correlation with patient outcome or thyroid hormone profile. PRISM score at 24 hours and T4 levels in the second sample were significant predictors of survival.

CONCLUSION

T3 levels reflect the patient's clinical status, T4 levels can predict survival.

摘要

目的

研究危重症患儿甲状腺激素谱及其与疾病严重程度和临床转归的关系。

方法

于 PICU 入院时和出院时/死亡前测定总血清三碘甲状腺原氨酸（T3）、甲状腺素（T4）和 TSH。

结果

病例组的平均 T3 水平明显低于对照组，在入院时和死亡前均低于死亡病例。T4 水平在病例组中较低，在死亡前也是如此。病例组和对照组的 TSH 水平无差异；存活组和死亡组之间也无差异。当 T3 和 T4 均低时，死亡风险增加 30 倍。与死亡患者不同，存活患者的血清 T3、T4 和 TSH 值有所改善。年龄、性别、住院时间、通气、正性肌力支持和 PICU 住院时间与患者预后或甲状腺激素谱均无相关性。24 小时 PRISM 评分和第二份样本中的 T4 水平是生存的显著预测因子。