Thyroid Hormone Level In ICU Patients And Its Clinical Significance

Objective:This study focuses on the correlation between thyroid hormone levels and the degree of critical illness in ICU patients and changes in thyroid hormone levels before and after etiological treatment of ICU patients,and explores the thyroid hormone levels before and after improvement of primary disease in the absence of thyroid hormone supplementation.Changes,guide clinicians to observe changes in ICU patients’ conditions and predict disease prognosis.Methods:The lowest score of each physiological indicators was collected within 24 to 48 hours of admission to ICU patients and acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ)(APACHE Ⅱ score table attached).APACHE Ⅱ score ≥8 points were included in the study.At the same time,at 6 am the following morning,fasting venous blood was collected from patients admitted to the ICU in accordance with the standard.Serum free triiodothyronine(FT3),serum free thyroxine(FT4),and thyroid stimulating hormone(TSH)were also collected and tested,and three groups were detected again after the patient’s primary disease improved.According to the APACHE Ⅱ score,the included patients were divided into 3 groups: non-critical reorganization(8points ≤ score <16 points);risk reorganization(16 points ≤ score <20 points);extremely critical reorganization(score ≥ 20 points).At the same time,30 healthy checkups in the physical examination center of the hospital were selected as a control group and collected three results.Statistical methods were used to compare the levels of thyroid hormones before and after treatment,between the death group and the survivalgroup.Finally,we analyzed the correlation between FT3,FT4,and TSH and APACHE Ⅱ scores before treatment in ICU patients.Results:(1)There was no statistical difference in FT3,FT4,and TSH levels between the control group and the three groups of ICU patients(P>0.05).(2)Control group and the three groups before treatment FT3,FT4 and TSH levels were compared:(1)There was a statistically significant difference in FT3 between the four groups(H=59.465,P<0.001).After comparison,it was found that there was a statistically significant difference between the control group and the three groups of FT3(all P<0.001 after adjustment);there was a statistically significant difference between the non-risk recombination and the extremely critically-recombinant FT3(adjusted P=0.015).Non-dangerous recombination and dangerous recombination,critical recombination and extremely dangerous recombinant FT3 were not statistically significant(P>0.05).(2)There was statistical difference in FT4 between the four groups(F=11.789,P<0.01).After comparison,it was found that the control group was different from the three groups of FT4(P<0.05);the other two were not statistically significant(P>0.05).(3)There was no statistical difference in four groups of TSH(F=1.166,P>0.05).(3)The levels of FT3,FT4 and TSH before and after treatment in the three groups of ICU survivors were compared:(1)The FT3 and FT4 were statistically significant before and after treatment in non-risk ICU patients(P<0.05),and there was no statistically significant difference in TSH(P>0.05).(2)The risk of FT3 and FT4 before and after treatment in patients with critically ill ICU were statistically significant(P<0.05),and there was no statistically significant difference in TSH(P>0.05).(3)The FT3 in the extremely critically ill recombinant ICU patients was statistically significant before and after treatment(P<0.05),and the FT4 and TSH were not statistically significant(P>0.05).(4)The levels of FT3,FT4,and TSH before treatment in the patients of death group and survival group were significantly different(P<0.05)between the two groups;therewas no significant difference in FT4 and TSH between the two groups(all P>0.05).(5)The correlations between APACHE Ⅱ scores of selected ICU patients and pre-treatment FT3,FT4,and TSH: FT3,FT4,and APACHE Ⅱ scores were negatively correlated(r =-0.404,-0.298,respectively;P all <0.01),while TSH and APACHE There was no significant correlation between Ⅱ scores(r=-0.086,P>0.05).Conclusion:(1)ICU patients are prone to NTIS,and FT3 and FT4 can be improved compared to admission when the condition is improved;,and the main manifestations are FT3 and FT4 declines,Patients with ICU are prone to thyroid hormone abnormalities,and FT3 and FT4 can be improved when hospitalization is improved.(2)FT3 and FT4 showed a significant negative correlation with APACHE Ⅱ score,which was a predictor of changes in ICU patient’s condition.