[Early changes in function of hypothalamic-pituitary-target gland axis in patients with severe sepsis and septic shock].
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue
; 19(6): 332-5, 2007 Jun.
Article
in Zh
| MEDLINE
| ID: mdl-17577436
ABSTRACT
OBJECTIVE:
To investigate the early changes in function of hypothalamic-pituitary-target gland (HPTG) axis in patients with severe sepsis and septic shock, in order to clarify its relationship with severity and prognosis of the patients.METHODS:
The serum contents of cortisol (F), triiodothyronine (T(3)), thyroxine (T(4)), thyrotropic-stimulating hormone (TSH), growth hormone (GH), follicle-stimulating hormone (FSH), luteotropic hormone (LH), prolactin (PRL) and plasma concentration of adrenocorticotrophic hormone (ACTH) in 10 severe sepsis and 12 septic shock patients on day 1, 3, 5 after diagnosis was made, and 12 patients with no infection or septic shock served as controls. The hypothalamic-pituitary adrenal gland axis (HPAA) function of the patients with severe sepsis and septic shock were evaluated with 1 microgram ACTH stimulation test given 1 day after the concentrations of the above hormones were determined.RESULTS:
Compared with the control patients, ACTH, T(3), T(4), GH, FSH, LH and PRL levels were significantly changed in patients with severe sepsis and septic shock (P<0.05 or P<0.01). The numbers of patients with reaction to 1 microgram ACTH stimulation test were similar between patients with severe sepsis (6 cases non-reaction and 3 cases reaction) and patients with septic shock (9 cases non reaction and 2 cases reaction, P>0.05). According to the acute physiology and chronic health evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) score, changes in ACTH, T(3), T(4), GH and PRL levels were closely related to the severity of illness (P<0.05 or P<0.01). Significant differences were found in ACTH, T(3), T(4) levels between survivors and non-survivors (P<0.05 or P<0.01). ACTH, T(4) levels and SOFA score were independent predictors of the 28-day hospital mortality (P<0.05 or P<0.01).CONCLUSION:
The early changes in HPTG axis are closely related with the severity and hospital mortality in patients with severe sepsis and septic shock.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock, Septic
/
Sepsis
/
Hypothalamo-Hypophyseal System
Type of study:
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
Zh
Journal:
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue
Journal subject:
MEDICINA DE EMERGENCIA
/
TERAPIA INTENSIVA
Year:
2007
Type:
Article
Affiliation country:
China