非甲状腺性病态综合征对老年男性肺部感染患者预后的影响

Nonthyroidal illness syndrome affected prognosis of pulmonary infection in elderly male patients

  • 摘要: 目的 了解非甲状腺性病态综合征(nonthyroidal illness syndrome,NTIS)对老年男性肺部感染住院患者死亡率的影响。 方法 采用横断面调查的方法,选取2012年1月- 2013年12月于我院因肺部感染住院的年龄 ≥ 60岁男性患者为研究对象,共239例。根据患者是否合并NTIS分为NTIS组和甲状腺功能正常组。分析两组炎症指标的差异、T3水平与炎症指标的关系、炎症指标和T3水平对生存率的影响。 结果 两组WBC(8.2±4.0)×109/L vs (6.8±2.4)×109/L,P=0.008、中性粒细胞比例(0.7%±0.1% vs 0.6%±0.1%,P=0.015)、CRP水平(4.9±5.1) mg/L vs (2.6±2.8) mg/L,P=0.002、抗生素使用时间(34.8±29.2) d vs (20.9±20.7) d,P< 0.001差异有统计学意义,NTIS组均高于甲状腺功能正常组。相关分析显示,TT3与CRP(r=-0.258,P< 0.001)、WBC(r=-0.207,P=0.001)、中性粒细胞比例(r=-0.184,P=0.004)、抗生素使用时间(r=-0.196,P=0.002)均呈负相关,FT3与CRP(r=-0.264,P< 0.001)、WBC(r=-0.199,P=0.002)均呈负相关。NTIS组的累计生存率(67.2%)低于甲状腺功能正常组(79.4%)(P=0.007)。以TT3和FT3建立Cox回归模型,矫正年龄因素后,随着FT3和TT3水平的增加,死亡率下降(P< 0.05)。 结论 在肺部感染的老年男性住院患者中,合并NTIS的患者病情更重,2年生存率更低。

     

    Abstract: Objective To understand the influence of nonthyroidal illness syndrome (NTIS) on mortality in the elderly male patients hospitalized for pulmonary infection. Methods Cross-sectional study was conducted in 239 male subjects aged 60 or over who were hospitalized for pulmonary infection from January 2012 to December 2013. All patients were divided into NTIS group and control group according to whether the patient was with NTIS or not. The differences in inflammatory markers, the correlation between inflammatory markers and T3, and the influence of T3 on survival were analyzed. Results There were statistically significant differences in WBC(8.2±4.0)×109/L vs (6.8±2.4)×109/L, P=0.008, neutrophil proportion (0.7%±0.1% vs 0.6%±0.1%, P=0.015, CRP (4.9±5.1) mg/L vs (2.6±2.8) mg/L, P=0.002, length of antibiotic use(34.8±29.2) d vs (20.9±20.7) d, P< 0.001 between NTIS group and control group. Pearson correlation analysis showed that there were negative correlations between TT3 and CRP (r=-0.258, P< 0.001), WBC (r=-0.207, P=0.001), neutrophil proportion (r=-0.184, P=0.004), length of antibiotic use (r=-0.196, P=0.002), between FT3 and CRP (r=-0.264, P< 0.001), WBC (r=-0.199, P=0.002). The cumulative survival rate of NTIS group was significantly lower than that of control group (67.2% vs 79.4%, P=0.007). Multivariate Cox regression analysis showed that the overall mortality decreased with the increase of FT3 and TT3 levels after adjusting age (P< 0.05, respectively). Conclusion Patients with NTIS show more severe conditions and lower 2-year survival rate.

     

/

返回文章
返回