Analysis Of The Correlation Between Thyroid Function And Mortality In Critically Ill Patients

Objective: Critically ill patients often have a variety of stress stimulation.In fact,the nature of these reactions is a manifestation of the changes in the body’s environment and the antagonism of external stimuli.When the body is stressed,the circulation of the thyroid hormone in the blood also changes.The hypothalamic pituitary thyroid axis and hepatic deiodinated enzyme system play an important role in hormone regulation and which will have functional disorders under the stimulation of cytokines and inflammatory mediators in the body and eventually lead to changes in the level of serum thyroid hormone.In clinical work,we often find that thyroid hormone levels in some critically ill patients are more likely to change than those in normal people.However,there have no special pathological changes in thyroid gland and the level of thyroid hormone can be restored to normal with the relief of their own diseases.This phenomenon is called euthyroid sick syndrome(ESS).Since the pathogenesis of ESS is not yet clear,more and more scholars have paid attention on it in recent years.Methods:1.100 ICU patients with normal thyroid function admitted from January 2016 to September 2017 in our hospital ICU were selected randomly in the study.Their basic information was recorded.The APACHE II scores of these patients were greater than or equal to 15 points within 24 hours of admission.Patients with hypothalamic and pituitary disease,combined with other hormones(gonad and adrenal axis)disorders,hyperparathyroidism,malignant tumors or autoimmune diseases,pregnancy or lactation,recently used immunosuppressive drugs or corticosteroids,thyroid dysfunction before and these who take drugs that affect thyroid function were excluded.The patients enrolled in the study were divided into the surviving group and the death group.The experimental data of the study were statistically analyzed by SPSS 19.The normality of data is tested,and the data is a normal distribution after square root transformation.T test was used in the measurement data,which was reflected by X± S.Counting data were checked by chi square test.The correlation analysis between hormone level and age was analyzed by Pearson correlation analysis.All statistical results were expressed by P.There were statistical differences when P < < 0.05.2.Electrochemiluminescence immunoassay(ECLI)was used to detect the levels ofTT3,FT3,TT4,FT4 and TSH in each patient.The levels of TT3,FT3,TT4,FT4 and TSH in the survival group and the death group were compared.3.The relationship between the levels of TT3,FT3,TT4,FT4 and TSH and mortality was observed.4.The relationship between age and TT3,FT3,TT4,FT4 and TSH levels was observed.Results:1.TT3,FT3 levels in the survival group and death group were different and have statistical difference.However,TT4,FT4 and TSH levels between the survival group and death group were not statistically significant;2.The TSH level was linearly related to the age of the critically ill patients,while the levels of TT3,FT3,TT4 and FT4 were not linearly related to the age of the critically ill patients.Conclusions:1.The thyroid hormone levels in critically ill patients are closely related to their prognosis2.The worse the severity of the critically ill patients,the lower the level of thyroid hormone TT3,FT3 and the mortality of critically ill patients are related to the thyroid hormone levels.3.TSH levels were linearly related to the age of critically ill patients.4.LowTT3,FT3 is an independent predictor of mortality in critically ill patients.5.The level of serum thyroid hormone TT3,FT3 has a good guiding significance for the prognosis of critically ill patients.