非甲状腺综合征对急性心力衰竭患者院内结局的影响

doi:10.3969/j.issn.1002-1949.2018.04.008

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (4): 314- DOI: 10.3969/j.issn.1002-1949.2018.04.008

Effect of nonthyroidal illness syndrome on hospital outcome in patients with acute heart failure

Wang Rui, Dong Tian-fu, Shen Jun, Li Shu-qin, Huang Tao, Wang Ying, Kang Xiu-wen

Department of Breast and Thyroid, the First People′s Hospital of Lianyungang City, Lianyungang 222000, China

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Abstract Objective To evaluate the correlation between the level of free serum triiodothyronine(FT3) in hospitalized patients with acute heart failure (HF) and the outcome of patients in hospital. Methods A total of 189 HF patients who were treated in the intensive care unit of Department of Cardiology in our hospital were selected. On the first day and the seventh day after admission, the patients′ serum FT3 indexes were detected. The patients were divided into the low FT3 group(n=91) and the normal FT3 group(n=98) according to whether the patients had the nonthyroidal illness syndrome (NTIS). The clinical data of the two groups and the outcome of the hospital were compared. The multivariate linear regression model was used to evaluate the correlation between patients′ hospitalization time and other variables. Logistic regression analysis was used to evaluate the independent factors of the patient′s time of hospitalization. Results The admission FT3 levels was negatively correlated with the patient′s length of stay (R=-0.590, P=0.013). Compared with the normal FT3 group, the hospitalization time［12(8, 25)d vs. 8(7, 20)d, Z=5.268, P＜0.001］ and the percentage of patients with invasive mechanical ventilation ［8.8%(8/91) vs. 2.0%(2/98), χ2=28.841, P＜0.001］ in the low FT3 group were significantly increased. There was no statistically significant difference in mortality between the low FT3 group and the normal FT3 group ［2.2% (2/91) vs. 0, χ2=1.154, P=0.283］. The level of FT3 was independent of the patient′s hospitalization time ［OR=0.617, 95%CI 0.494～0.770, P＜0.001］. On the 7th day after admission, the T3 index of 25 patients with low FT3 returned to normal (T3 recovery group, n=25). Compared with 66 patients without T3 recovery (T3 non-recovery group, n=66), the hospitalized time, the proportion of patients with invasive mechanical ventilation, the proportion of patients admitted to hospital in T3 recovery group patients were significantly lower (P all<0.05). Conclusion Low T3 levels indicate a poor hospital outcome in acute HF patients. Doctors can stratify patients at risk according to the different levels of FT3 at admission to HF patients, and further give different treatment to HF patients. The return of low T3 levels can significantly improve the patient′s hospital outcome.

Key words： Heart failure Nonthyroid syndrome Free three iodide adenosine（FT3）

About author:: Wang Rui, E-mail: wangrui22018@163.com

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	Wang Rui
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	Li Shu-qin
	Huang Tao
	Wang Ying
	Kang Xiu-wen

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Wang Rui,Dong Tian-fu,Shen Jun, et al. Effect of nonthyroidal illness syndrome on hospital outcome in patients with acute heart failure[J]. Chinese Journal of Critical Care Medicine, 2018, 38(4): 314-.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.04.008 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I4/314

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