重型颅脑损伤患者甲状腺功能异常的临床分析
《创伤外科杂志》[ISSN:/CN:]
- 期数:
- 2020年09期
- 页码:
- 681-683
- 栏目:
- 短篇论著
- 出版日期:
- 2020-09-20
文章信息/Info
- Title:
- Clinical analysis of abnormal thyroid hormone in patients with severe traumatic brain injury
- Author(s):
- LIN Chao; LI Zheng; LIU Ning; LU Hua
- Department of Neurosurgery,Jiangsu Provincial People's Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China
- 分类号:
- R 651.1
- DOI:
- 10.3969j.issn.1009-4237.2020.09.009
- 文献标识码:
- A
- 摘要:
- 目的 研究重型颅脑损伤患者游离甲状腺激素的变化情况,探讨导致游离甲状腺激素变化的危险因素,分析游离甲状腺激素变化与患者预后的关系。方法 回顾性分析2017年6月—2018年6月江苏省人民医院神经外科收治重型颅脑损伤且无甲状腺原发病患者45例,男性26例,女性19例; 年龄19～65岁,平均36.5岁。随访1年,根据促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)变化分为甲状腺功能减退组(32例)和正常组(13例)。通过GOS评分探讨患者治疗后恢复情况,并且分析患者肺部感染、急性胃肠炎、胃出血、腹胀、消化道穿孔等并发症的发生率。应用统计学分析,探讨FT4异常与患者预后的相关性。结果 共32例(32/45例,71.11%)患者出现甲状腺功能减退。患者的年龄、性别、致伤原因、GCS评分等与甲状腺功能减退无关。甲状腺功能减退组患者的ICU时间、肺炎的发生率与正常组比较差异无统计学意义,但预后较差(GOS≤3分,P=0.043)、消化道并发症的发生率显著增加(P=0.026)。Logistic回归分析提示甲状腺功能减退(OR=2.782,P=0.036)是重型颅脑损伤患者预后不良的独立危险因素。结论 甲状腺功能减退是重型颅脑损伤患者常见病发症之一,重型颅脑损伤患者出现FT3或FT4下降较为常见,提示患者预后不良。
参考文献/References
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备注/Memo
- 备注/Memo:
- 【基金项目】 国家自然科学基金青年基金(81901258) 【通信作者】 路华,E-mail:luhua@njmu.edu.cn
