Department of Intensive Care Medicine, AP-HP, Raymond Poincaré Hospital, University Versailles Saint-Quentin en Yvelines, 104 bd Raymond Poincaré, Garches F-92380, France.
Crit Care. 2011;15(1):R47. doi: 10.1186/cc10010. Epub 2011 Feb 3.
The aim of this study was to determine the relationship between hormonal status and mortality in patients with protracted critical illness.
We conducted a prospective observational study in four medical and surgical intensive care units (ICUs). ICU patients who regained consciousness after 7 days of mechanical ventilation were included. Plasma levels of insulin-like growth factor 1 (IGF-1), prolactin, thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS) and cortisol were measured on the first day patients were awake and cooperative (day 1). Mean blood glucose from admission to day 1 was calculated.
We studied 102 patients: 65 men and 37 women (29 of the women were postmenopausal). Twenty-four patients (24%) died in the hospital. The IGF-1 levels were higher and the cortisol levels were lower in survivors. Mean blood glucose was lower in women who survived, and DHEA and DHEAS were higher in men who survived.
These results suggest that, on the basis of sex, some endocrine or metabolic markers measured in the postacute phase of critical illness might have a prognostic value.
本研究旨在确定延长危重病患者的激素状态与死亡率之间的关系。
我们在四个内科和外科重症监护病房（ICU）进行了一项前瞻性观察性研究。纳入了机械通气 7 天后意识恢复的 ICU 患者。在患者清醒并合作的第一天（第 1 天）测量胰岛素样生长因子 1（IGF-1）、催乳素、促甲状腺激素、卵泡刺激素、黄体生成素、雌二醇、孕酮、睾酮、脱氢表雄酮（DHEA）、硫酸脱氢表雄酮（DHEAS）和皮质醇的血浆水平。从入院到第 1 天的平均血糖也进行了计算。
我们研究了 102 名患者：65 名男性和 37 名女性（29 名女性处于绝经后状态）。24 名患者（24%）在医院死亡。幸存者的 IGF-1 水平较高，皮质醇水平较低。女性幸存者的平均血糖较低，而男性幸存者的 DHEA 和 DHEAS 水平较高。
这些结果表明，基于性别，一些在危重病后急性期测量的内分泌或代谢标志物可能具有预后价值。
