The Research on the Changes and Prognosis of Thyroid Hormone Levels in Critically Ill Patients

Objective: To many non-thyroid systemic disease, trauma, surgery can cause abnormal levels of thyroid hormone in the body, called euthyroid sick syndrome (ESS). ESS mechanism is not clear, the role of cytokines which has attracted the attention of many scholars. Thyroid hormone levels change, our study of critically ill patients to explore the law of ESS incidence in critically ill patients. This study of critically ill patients with APACHE Ⅱ scoring combined with levels of thyroid hormone cable investigate the correlation to judge the severity of the condition of critically ill patients, and to understand the variation of critically ill patients with thyroid hormone and clinical significance. Score: 1 pair of critically ill patients admitted to the ICU APACHE II scoring system, the patients were divided into mild (non-critical and ratings lt by rating results; 16), moderate (critical score to 16-20), severe (very critically, ratings gt; 20) three groups. Replacement of 60 cases of healthy adults as a control group. The measuring technique of radioimmunoassay (RIA) detection of mild, moderate and severe groups of patients serum thyroid hormone levels (TT3, FT3, TT4, FT4, TSH), compared with the normal control group. Thyroid hormone level was observed. 3 observed correlation between thyroid hormone levels and the severity of the patient's condition. Results: critically ill patients with APACHE Ⅱ score grouping with thyroid hormone measurement results of the comparison result, TT3, FT3, FT4 mild, moderate, severe decreased significantly compared with the normal control group difference was statistically significant. TSH mild, moderate and severe control group dropped more significant, TT4 before and after treatment in each group was statistically significant .2 thyroid hormone levels APACHE Ⅱ score analysis show TT3, FT3, FT4, TSH's level and APACHE Ⅱ scores were negatively correlated. The correlation coefficient of -0.539, -0.662, -0.354, -0.826.3 death group and survival group, plasma levels of thyroid hormones compared death group TT3, FT3, FT4, TSH content was significantly lower than the survival group, the difference was statistically significant. Conclusion: a critical illness associated with thyroid hormone changes. 2 critically ill patients the more severe the disease, the thyroid hormone and TSH levels were significantly lower (in addition to the TT4 outside), the severity and thyroid hormone levels are relevant. The the 3 outcome worsening TH and TSH levels significantly lower than before treatment the outcome improved group group. Thyroxine levels in the outcome improved after treatment than before treatment. Outcome the worsening treatment before and after thyroxine levels lower than before treatment. 5 serum thyroid hormone levels were negatively correlated with APACHE Ⅱ. Of 6 serum thyroid hormone levels prognosis good guide. 7 thyroid sick syndrome is not its treatment.