Study on the relationship between endocrine hormone and prognosis in critically ill patients / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the profile and significance of changes in thyroid function and cortisol in critically ill patients.</p><p><b>METHODS</b>Chemiluminescent microparticle immunoassay (CMIA) was used to measure the serum thyroid hormone, thyroid stimulating hormone and cortisol levels in 51 patients at the first day and in the 45 patients still alive at the third day after hospitalized in ICU. In the 45 patients, 17 cases were complicated with multiple organ dysfunction syndrome (MODS) and 28 cases were not. The age, blood glucose levels and APACHE II scores were also recorded at the first day.</p><p><b>RESULTS</b>In the 45 patients, serum FT(3) decreased in 41 patients (91%), cortisol increased in 33 patients (73%), especially in the first 24 hours. Compared with non-MODS group, serum FT(3), FT(4) and cortisol levels changed significantly in MODS group. Serum FT(4) reduced apparently in 6 dead patients. Serum FT(3) level was negatively correlated with APACHE II, and cortisol level was positively correlated with APACHE II.</p><p><b>CONCLUSIONS</b>Thyroid hormone and cortisol were apparently abnormal and correlated with APACHE II score, especially in patients with MODS. Serum FT(4) might serve as an index to judge the prognosis of the patients.</p>