CAJ | 학술논문

目的：研究低T3综合征与糖尿病患者发生肺部感染的相关性，以期为住院糖尿病患者发生肺部感染的预后提供指导。方法选取2011年1月－2014年12月住院的糖尿病发生肺部感染患者100例，将患者分为A组（糖尿病合并重症肺炎组）和B组（糖尿病合并普通肺炎组）各50例，选取同期住院的无肺部感染糖尿病患者50例作为C组（对照组），将A组患者住院期间及随访期间死亡的归为死亡组，存活的为存活组，比较各组患者低血清三碘甲状腺原氨酸（T3）综合征与病情及预后的关系。结果 A组患者的血清游离 T3（FT3）、T3、甲状腺素（T4）含量明显较B、C组低，差异有统计学意义（P＜0．05），B、C两组差异无统计学意义，3组患者FT4、血清促甲状腺素（TSH）含量差异无统计学意义；A组患者的超敏C‐反应蛋白（hs‐CRP）、糖化血红蛋白（HbAlC）含量高于B、C组，氧合指数（PaO2／FiO2）的含量低于B组，B组患者的hs‐CRP含量高于C组，以上指标比较差异均有统计学意义（P＜0．05）；A组患者的 T3、FT3含量与hs‐CRP、HbAlC成负相关，与PaO2／FiO2成正相关；死亡组患者的TSH、T3、T4含量明显低于对照组，两组比较差异有统计学意义（P＜0．05）。结论低 T3综合征可以反映住院糖尿病患者并发肺部感染的病情严重程度，对重症肺炎患者的预后有一定的指导价值。
목적：연구저T3종합정여당뇨병환자발생폐부감염적상관성，이기위주원당뇨병환자발생폐부감염적예후제공지도。방법선취2011년1월－2014년12월주원적당뇨병발생폐부감염환자100례，장환자분위A조（당뇨병합병중증폐염조）화B조（당뇨병합병보통폐염조）각50례，선취동기주원적무폐부감염당뇨병환자50례작위C조（대조조），장A조환자주원기간급수방기간사망적귀위사망조，존활적위존활조，비교각조환자저혈청삼전갑상선원안산（T3）종합정여병정급예후적관계。결과 A조환자적혈청유리 T3（FT3）、T3、갑상선소（T4）함량명현교B、C조저，차이유통계학의의（P＜0．05），B、C량조차이무통계학의의，3조환자FT4、혈청촉갑상선소（TSH）함량차이무통계학의의；A조환자적초민C‐반응단백（hs‐CRP）、당화혈홍단백（HbAlC）함량고우B、C조，양합지수（PaO2／FiO2）적함량저우B조，B조환자적hs‐CRP함량고우C조，이상지표비교차이균유통계학의의（P＜0．05）；A조환자적 T3、FT3함량여hs‐CRP、HbAlC성부상관，여PaO2／FiO2성정상관；사망조환자적TSH、T3、T4함량명현저우대조조，량조비교차이유통계학의의（P＜0．05）。결론저 T3종합정가이반영주원당뇨병환자병발폐부감염적병정엄중정도，대중증폐염환자적예후유일정적지도개치。
OBJECTIVE To study the correlation between the low T3 syndrome and the severity of illness condition of the diabetic mellitus patients complicated with pulmonary disease so as to provide guidance for the prognosis of the hospitalized diabetic mellitus patients complicated with pulmonary infections .METHODS A total of 100 diabetic mellitus patients complicated with pulmonary infections who were hospitalized from Jan 2011 to Dec 2014 were en‐rolled in the study and divided into the group A (the diabetic mellitus with complicated severe pneumonia group) and the group B (the diabetic mellitus with complicated ordinary pneumonia group) ,with 50 cases in each group;meanwhile ,50 diabetic mellitus patients without pulmonary infections who were hospitalized during the same peri‐od were set as the group C (the control group);the patients of the group A who died during the hospital stay and follow‐up were assigned as the death group ,the survived as the survival group;the relationship between the low serum triiodothyronine (T3) syndrome and the illness condition and prognosis was observed and compared . RESULTS The contents of serum free T3(FT3) ,T3 ,and thyroxin(T4) of the group A were significantly lower than those of the group B an the group C(P<0 .05) ,however ,there was no significant difference between the group B and the group C ,there was no significant difference in the FT4 or serum thyroid stimulating hormone (TSH) content among the three groups .The contents of high‐sensitivity C‐reactive protein(hs‐CRP) and glycosy‐lated hemoglobin(HbAlC) of the group A were higher than those of the group B and the group C ,the content of oxygenation index(PaO2/FiO2 ) of the group A was lower than that of the group B ,the content of hs‐CRP of the group B was higher than that of the group C ,and there was significant difference in the above indicators (P<0 .05) .The contents of T3 and FT3 of the group A were negatively correlated with the Hs‐CRP and HbAIC and positively correlated with PaO2/FiO2 ;the contents of TSH ,T3 ,and T4 of the death group were significantly lower than those of the control group , with statistical difference between the two groups ( P < 0 .05 ) . CONCLUSION The low T3 syndrome can reflect the severity of illness condition of the hospitalized diabetic melli‐tus patients with complicated pulmonary infections ,and it has certain guidance value in the prognosis of the pa‐tients with severe pneumonia .