Evaluating value of thyroid hormone and procalcitonin and C-reactive protein in patients with sepsis

doi:10.3877/cma.j.issn.1674-1358.2016.02.007

Abstract

Abstract:

Objective

To investigate the evaluating value of thyroid hormone, procalcitonin and C-reactive protein in patients with sepsis by analyzing the state of the disease and fatality.

Methods

According to 2008 international guidelines for management of severe sepsis and septic shock, patients were classified into 3 groups: sepsis group, severe sepsis group (including severe sepsis and septic shock patients) and non-systemic inflammatory response syndrome (SIRS) group (control group), all the data were analyzed, retrospectively. According to the hospital mortality, the two septic groups were divided into survival group and death group. The plasma thyroid hormone, procalcitonin and C-reactive protein levels were detected in 24 h after patients in admission.

Results

In the severe sepsis group, levels of FT₃, TT₃ and TT₄ were significantly lower than those in sepsis and control groups (P all < 0.05). In the sepsis group, levels of FT₃ and TT₃ were lower than those in control group (P all < 0.05). In the sepsis and severe sepsis groups, levels of PCT and CRP were significantly higher than those in control group (P all < 0.05). In the severe sepsis group, the level of PCT was higher than those in sepsis group (P < 0.05), but there was no significant difference in the levels of CRP between the two groups. In the death group FT₃, TT₃ and PCT were significantly higher than those in survival group (P all < 0.05), but the difference of CRP had no significant difference. TSH had no significant difference in all group.

Conclusions

CRP is a useful parameter to differentiate SIRS from non-SIRS, which is not reliable indicator for the early diagnosis in patients with sepsis. PCT and TH are more specific indicators in early diagnosis of sepsis. TH and PCT could be used to predict the severity of sepsis. TH and PCT were significantly relevant to the prognosis of sepsis. TH combined with PCT are hopefully quick, reliable and non-invasive indicators in early evaluation of the prognosis of sepsis.

Key words: Sepsis, Thyroid hormone, Procalcitonin, C-reactive protein

Xiaoyan Yin, Jian’ou Qiao. Evaluating value of thyroid hormone and procalcitonin and C-reactive protein in patients with sepsis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(02): 162-165.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1358.2016.02.007

https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2016/V10/I02/162

Figures/Tables 2

References 17

[1]	Dellinger RP, Levy MM, Carlet JM, el al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008[J]. Crit Care Med,2008,36(1):296-327.
[2]	中华医学会急诊医学分会危重病专家委员会，中国中西医结合学会急救医学专业委员会. 脓毒症的定义,诊断标准,中医证候诊断要点及说明(草案)[J]. 中华急诊医学杂志,2007,16(8):797-798.
[3]	Lundberg JS, Perl TM, Wiblin T, el al. Septic shock: an analysis of outcomes for patients with onset on hospital wards versus intensive care units[J]. Crit Care Med,1998,26(6):1020-1024.
[4]	Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care[J]. Crit Care Med,2001,29(7):1303-1310.
[5]	Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference[J]. Crit Care Med,2003,31(4):1250-1256.
[6]	Chopra IJ. Euthyroid sick syndrome: abnormalities in circulating thyroid hormones and thyroid hormone physiology in non-thyroid illness[J]. Medical Grand Rounds,1982,1(1):201-212.
[7]	Mebis L, Van den Berghe G. Thyroid axis function and dysfunction in critical illness[J]. Best Pract Res Clin Endocrinol Metab,2011,25(5):745-757.
[8]	Van den Berghe G. Non-thyroidal illness in the ICU: a syndrome with different faces[J]. Thyroid,2014,24(10):1456-1465.
[9]	朱淑芬，周丽华，黄志民, 等. 脓毒症患者甲状腺激素水平和血清氨基末端脑钠肽前体变化及其相关性[J]. 内科急危重症杂志,2014,20(2):96-97.
[10]	Irwin AD, Carrol ED. Procalcitonin[J]. Arch Dis Child Educ Pract Ed,2011,96(6):228-233.
[11]	胡可，刘文恩，梁湘辉. 降钙素原在细茵感染中临床应用的研究[J]. 中华医院感染学杂志,2011,21(1):44-47.
[12]	Claeys R, Vinken S, Spapen H, et al. Plasma procalcitonin and C-reactive protein in acute septic shock：clinical and biological corerlates[J]. Criti Care Med,2002,30(4):17-31.
[13]	朱名超，韩利蓉，孙莉, 等. 降钙素原与超敏C-反应蛋白在感染性和非感染性疾病中的应用价值评价[J/CD]. 中华实验和临床感染病杂志:电子版,2015,9(1):37-39.
[14]	Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet,1993,341(8844):515-518.
[15]	李志彬，司金春，战伟, 等. 血清降钙素原及急性生理与慢性健康评分Ⅱ监测对感染性休克患者病情及预后的评估价值研究[J/CD]. 中华实验和临床感染病杂志:电子版,2014,8(1):52-55.
[16]	毛燕青，李苏，王翎, 等. 血清超敏C-反应蛋白和前白蛋白在老年COPD患者中的变化[J]. 中国老年学杂志,2010,30(19):2723-2725.
[17]	邢豫宾，戴路明，赵芝焕, 等. 血清降钙素原和常用炎症指标结合SOFA评分对脓毒症早期诊断和预后价值的评价[J]. 中国危重病急救医学,2008,20(1):23-28.

组别	例数	CRP（mg/L）	TSH（uIU/ml）	TT₃（ng/ml）
严重脓毒症组	20	82.20 ± 1.38^a	1.36 ± 0.28	0.31 ± 0.02^ab
脓毒症组	23	78.90 ± 1.37^a	1.40 ± 0.26	0.52 ± 0.08^a
非SIRS对照组	30	8.90 ± 0.59	1.26 ± 0.27	1.03 ± 0.10
组别	例数	TT₄（ng/dl）	FT₃（pg/ml）	FT₄（ng/dl）	PCT（ng/ml）
严重脓毒症组	20	5.79 ± 0.26^ab	1.57 ± 0.07^ab	1.05 ± 0.02	8.48 ± 3.54^ab
脓毒症组	23	6.98 ± 1.06	2.30 ± 0.11^a	1.06 ± 0.02	2.53 ± 0.64^a
非SIRS对照组	30	7.27 ± 0.29	2.55 ± 0.10	1.08 ± 0.02	0.04 ± 0.01

组别	例数	CRP（mg/L）	TSH（uIU/ml）	TT₃（ng/ml）
严重脓毒症组	20	82.20 ± 1.38^a	1.36 ± 0.28	0.31 ± 0.02^ab
脓毒症组	23	78.90 ± 1.37^a	1.40 ± 0.26	0.52 ± 0.08^a
非SIRS对照组	30	8.90 ± 0.59	1.26 ± 0.27	1.03 ± 0.10
组别	例数	TT₄（ng/dl）	FT₃（pg/ml）	FT₄（ng/dl）	PCT（ng/ml）
严重脓毒症组	20	5.79 ± 0.26^ab	1.57 ± 0.07^ab	1.05 ± 0.02	8.48 ± 3.54^ab
脓毒症组	23	6.98 ± 1.06	2.30 ± 0.11^a	1.06 ± 0.02	2.53 ± 0.64^a
非SIRS对照组	30	7.27 ± 0.29	2.55 ± 0.10	1.08 ± 0.02	0.04 ± 0.01

组别	例数	CRP（mg/L）	TSH（uIU/ml）	TT₃（ng/ml）
存活组	29	89.22 ± 0.13	1.26 ± 0.02	0.59 ± 0.12
死亡组	14	90.16 ± 0.78	1.22 ± 0.08	0.30 ± 0.18^a
t值		-9.030	3.080	9.810
P值		0.688	0.109	0.001
组别	例数	TT₄（ng/dl）	FT₃（pg/ml）	FT₄（ng/dl）	PCT（ng/ml）
存活组	29	6.06 ± 0.09	2.34 ± 0.23	1.06 ± 0.06	2.21 ± 0.91
死亡组	14	5.96 ± 0.03	1.46 ± 0.24^a	1.12 ± 0.03	10.27 ± 2.85^a
t值		7.190	-4.330	0.590	-16.170
P值		0.210	0.002	0.061	0.001

组别	例数	CRP（mg/L）	TSH（uIU/ml）	TT₃（ng/ml）
存活组	29	89.22 ± 0.13	1.26 ± 0.02	0.59 ± 0.12
死亡组	14	90.16 ± 0.78	1.22 ± 0.08	0.30 ± 0.18^a
t值		-9.030	3.080	9.810
P值		0.688	0.109	0.001
组别	例数	TT₄（ng/dl）	FT₃（pg/ml）	FT₄（ng/dl）	PCT（ng/ml）
存活组	29	6.06 ± 0.09	2.34 ± 0.23	1.06 ± 0.06	2.21 ± 0.91
死亡组	14	5.96 ± 0.03	1.46 ± 0.24^a	1.12 ± 0.03	10.27 ± 2.85^a
t值		7.190	-4.330	0.590	-16.170
P值		0.210	0.002	0.061	0.001

Please choose a citation manager

Content to export