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目的研究甲状腺激素在高脂血症性急性胰腺炎患者中的变化和其对疾病严重程度的预测价值。方法选择2012年1月至2014年7月某院高脂血症性急性胰腺炎患者46例,根据疾病严重程度分为轻度急性胰腺炎和中度急性胰腺炎。检测生化肝肾功能和血脂,检测甲状腺激素指标包括游离三碘甲状腺原氨酸、总三碘甲状腺原氨酸、游离甲状腺素、总甲状腺素和促甲状腺激素。结果轻度急性胰腺炎患者的游离三碘甲状腺原氨酸、总三碘甲状腺原氨酸和促甲状腺激素均明显高于中度急性胰腺炎患者。总三碘甲状腺原氨酸、总甲状腺素和促甲状腺激素均与甘油三脂呈负相关(r分别为-0.325、-0.482和-0.328,P分别为0.027、0.001和0.026)。游离三碘甲状腺原氨酸是高脂血症性急性胰腺炎出现中度急性胰腺炎的危险因素。结论甲状腺激素水平随高脂血症性急性胰腺炎病情加重而降低,促甲状腺激素下降与甘油三脂升高有关,游离三碘甲状腺原氨酸可以作为早期预测高脂血症性急性胰腺炎严重程度的指标。
Objective To study the changes of thyroid hormones in patients with hyperlipidemic acute pancreatitis and their predictive value of disease severity. Methods From January 2012 to July 2014, 46 patients with hyperlipidemic acute pancreatitis in a hospital were divided into mild acute pancreatitis and moderate acute pancreatitis according to the severity of the disease. Detection of biochemical liver and kidney function and blood lipids, thyroid hormone testing indicators include free triiodothyronine, total triiodothyronine, free thyroxine, total thyroxine and thyroid stimulating hormone. Results Free triiodothyronine, total triiodothyronine and thyrotropin in patients with mild acute pancreatitis were significantly higher than those in moderate acute pancreatitis. Total triiodothyronine, total thyroxine and thyrotropin were negatively correlated with triglycerides (r = -0.325, -0.482 and -0.328, respectively, P = 0.027, 0.001 and 0.026, respectively). Free triiodothyronine is a risk factor for the development of moderate acute pancreatitis in hyperlipidemic acute pancreatitis. Conclusions Thyroid hormone levels decrease with the progression of hyperlipidemic acute pancreatitis. The decrease of thyrotropin is related to the increase of triglyceride. Free triiodothyronine can be used as an early predictor of severe acute hyperlipidemic pancreatitis Degree of indicator.