Department of Pediatrics, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China.
Department of Pediatric Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China.
BMC Pediatr. 2022 Nov 29;22(1):687. doi: 10.1186/s12887-022-03756-7.
Intensive physical stress in sepsis can induce the disorder of endocrine function and impact the clinical course and prognosis. Low T3 syndrome has been verified to be the predictive indicator of poor prognosis in several researches. Reports on the influence factors of thyroid hormonal levels in children with severe sepsis are rare. We aim to investigate the thyroid hormonal variations in the course of sepsis and analyze that how to be affected by clinical data and inflammatory biomarkers.
In the case-control study, 184 children with sepsis and 323 controls were included in Tongji Hospital, Wuhan, China, in 2019. Data on clinical and inflammatory parameters were collected from all participants. Circulating FT3(Free Triiodothyronine) levels were measured by Electrochemiluminescence immunoassay. Finally, we investigated the correlation between FT3 and related variables with linear regression analysis.
Serum FT3 was lower in the sepsis group than in control group(2.59 + 1.17 vs 2.83 + 1.01 pg/mL, p < 0.05). Significant moderately negative correlations(|r| > 0.3) of FT3 levels with ferritin, PCT, duration of symptoms, SOFA score, and mortality were revealed. Moreover, we observed that FT3 had the positive correlation with albumin, as well as white blood cell count.
Concentrations of serum FT3 are dramatically declined in sepsis children than in control children. Our results demonstrate that recognizing the potential abnormality of thyroid hormones in sepsis patients and examine timely through abnormal common clinical data and inflammatory biomarkers is a fine option.
脓毒症患者强烈的生理应激会导致内分泌功能紊乱，并影响疾病的临床进程和预后。多项研究证实，低 T3 血症是判断预后不良的预测指标。但关于严重脓毒症患儿甲状腺激素水平的影响因素的报道较少。我们旨在探讨脓毒症患儿甲状腺激素的变化，并分析其如何受到临床数据和炎症标志物的影响。
采用病例对照研究，纳入 2019 年于中国武汉同济医院的 184 例脓毒症患儿和 323 例对照者。收集所有参与者的临床和炎症参数数据。采用电化学发光免疫分析法检测游离三碘甲状腺原氨酸（FT3）水平。最后，我们采用线性回归分析探讨 FT3 与相关变量之间的相关性。
脓毒症组患儿血清 FT3 水平低于对照组（2.59±1.17 vs. 2.83±1.01 pg/mL，p<0.05）。FT3 水平与铁蛋白、降钙素原、症状持续时间、SOFA 评分和死亡率呈显著负相关（|r|>0.3）。此外，我们还观察到 FT3 与白蛋白和白细胞计数呈正相关。
脓毒症患儿血清 FT3 浓度明显低于对照组患儿。我们的研究结果表明，认识到脓毒症患者甲状腺激素的潜在异常，并通过异常的常规临床数据和炎症标志物及时检查是一种很好的选择。
