Mangas-Rojas A, García-Rojas J F, Barba Chacón A, Millán Núñez-Cortés J, Zamora-Madaria E
Departamento de Medicina Interna, Facultad de Medicina de Cádiz.
Rev Clin Esp. 1990 Nov;187(8):395-8.
The alterations in serum concentration of thyroxine (T4), tri-iodine-thyronine (T3), reverse tri-iodinetiroinine (rT3), thyrotropine (TSH and free thyroxine index (IT4L), are studied in 37 patients diagnosed of sepsis who were divided into two groups according to their evolution: Group A: 22 patients who evolved favourably, and Group B: 15 patients who died, as well as in 14 healthy controls; this was carried out in order to establish, on one hand, its prognostic value, and, on the other, which of these parameters is most useful in the evaluation of thyroid function in these patients. A decrease in serum T3 levels was observed in patients from both groups (p less than 0.001) which was accompanied by an increase in rT3 levels (p less than 0.001) and a decrease in It4L (p less than 0.001); No significant modifications were observed in T4 and TSH. On follow up of 12 patients from group A and 14 from group B, an increase in mean T3 concentration was observed (p less than 0.02) only in the first patient from both groups. The greatest discriminative efficacy of thyroid hormones study with an unfavorable sepsis evolution corresponded to a T3 value below 35 ng/dl.
对37例确诊为脓毒症的患者进行了研究，检测其血清甲状腺素（T4）、三碘甲状腺原氨酸（T3）、反三碘甲状腺原氨酸（rT3）、促甲状腺激素（TSH）和游离甲状腺素指数（IT4L）的变化。这些患者根据病情转归分为两组：A组：22例病情好转的患者；B组：15例死亡的患者。同时选取14名健康对照者进行检测。目的一方面是确定这些指标的预后价值，另一方面是确定在评估这些患者的甲状腺功能时，哪个参数最有用。两组患者的血清T3水平均下降（p<0.001），同时rT3水平升高（p<0.001），It4L下降（p<0.001）；T4和TSH未观察到显著变化。对A组12例患者和B组14例患者进行随访，仅在两组的首例患者中观察到平均T3浓度升高（p<0.02）。甲状腺激素研究对脓毒症病情转归不利的最大判别效能对应的T3值低于35 ng/dl。
