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目的探讨危重老年患者正常甲状腺功能病态综合征(ESS)与血清硒(Se)含量之间的关联及与疾病预后的关系。方法采用化学发光法检测血清甲状腺激素,根据甲状腺激素水平将100例ICU危重老年患者分成ESS组和非ESS组,35例健康体检者作为正常对照组。采用湿法消减-原子荧光光谱法检测所有研究对象的血清硒水平,比较各组血清硒水平是否存在差异。结果非ESS组与正常对照组血清甲状腺激素、血清硒水平比较,差异均无统计学意义(P>0.05)。ESS组Se、TT3、FT3水平低于正常对照组、非ESS组,ESS组FT4高于正常对照组、非ESS组,差异均有统计学意义(P<0.01),3组TSH和TT4水平差异均无统计学意义(P>0.05)。血清Se水平与TT3水平和FT3水平呈显著正相关(r值分别为0.781、0.819,P<0.01),与FT4水平呈负相关(r=-0.267,P<0.05)。结论危重老年患者ESS与血清硒水平降低相关,血清硒水平越低,甲状腺功能紊乱越严重。
Objective To explore the relationship between normal thyroid function syndrome (ESS) and selenium (Se) content in critically ill elderly patients and the relationship with disease prognosis. Methods Serum thyroid hormones were detected by chemiluminescence method. According to the levels of thyroid hormone, 100 critically ill elderly patients with ICU were divided into ESS group and non-ESS group, and 35 healthy subjects were used as normal control group. The serum selenium levels of all the subjects were detected by wet-subtractive-atomic fluorescence spectrometry, and whether there was any difference in serum selenium levels between the groups. Results Serum thyroid hormone and serum selenium levels in non-ESS group and normal control group had no significant difference (P> 0.05). The levels of Se, TT3 and FT3 in ESS group were lower than those in normal control group, non-ESS group and ESS group (P <0.01). The differences of TSH and TT4 levels in ESS group were higher than those in normal control group and non-ESS group No statistical significance (P> 0.05). Serum Se level was positively correlated with TT3 level and FT3 level (r = 0.781,0.819, P <0.01), but negatively correlated with FT4 level (r = -0.267, P <0.05). Conclusion ESS in critically ill elderly patients is associated with a decrease in serum selenium levels. The lower the serum selenium level, the more severe the thyroid dysfunction.