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1、脓毒症患者甲状腺功能和左心室功能改变相关性探究【摘要】目的探讨脓毒症患者甲状腺功能紊乱的发生情况及其与左心室结构、功能变化的关系。方法入选63例脓毒症患者，入院次日测定血清甲状腺激素和C反应蛋白（CRP）水平，记录患者入院时年龄、性别、疾病、APACHEII评分和后期发生休克及多器官功能障碍综合征（MODS）等一般资料，并在入院24h、第2周、第3周动态观察左心室结构及功能的变化。另选择一般感染组患者（38例）作对照组,比较脓毒症组与对照组甲状腺功能的差别以及早期血清甲状腺激素水平在脓毒症患者不同严重程度的心脏结构及功能改变间的差异性。结果脓毒症
2、患者血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺（FT4）水平均明显低于一般感染组（P0,05）,其左心室变化表现为：左心室舒张功能减低（I型）31例，左心室扩大和左心室舒张功能减低（II型）18例，左心室扩大、左心室收缩和舒张功能减低（III型）14例；与I、II型比较，III型患者血清FT3、FT4水平显著降低，休克及MODS发生率显著升高而I、II型患者间上述指标差异均无统计学意义。结论脓毒症患者普遍存在甲状腺功能紊乱，早期血清甲状腺激素水平对疾病后期左心室结构和功能病变具有一定预测作用。【关键词】脓毒症；左心室；超声心动图；甲状腺激素;
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