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甲状腺疾病综合征的感染性休克患者的三甲状腺激素补充疗法:两项试点,安慰剂控制,随机化试验
Mirza Kovacevic1, Visnja Nesek Adam2, Senada Causevic1
1Department of Anesthesiology, Resuscitation and Intensive Care, Cantonal Hospital, Zenica, Bosnia and Herzegovina; Faculty of Medicine, Zenica, Bosnia and Herzegovina.
Anaesthesia, critical care & pain medicine
|December 7, 2023
概括
三甲状腺素 (T3) 补充剂在低T3T4水平的败血症休克患者中改善了生存率,但在低T3无甲状腺病综合征 (ESS) 患者中增加了死亡率. 在败血症中使用甲状腺激素时建议谨慎使用.
科学领域:
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
- 内部医学 内部医学
背景情况:
- 甲状腺疾病综合征 (ESS) 在败血性休克患者中很常见.
- 甲状腺激素水平,特别是三甲状腺素 (T3),可能会影响结果.
- 试点研究调查T3补充剂在两个ESS子组.
研究的目的:
- 评估三甲状腺素 (T3) 补充剂对带有甲状腺疾病综合征 (ESS) 的败血症休克患者28天生存期的影响.
- 评估二次结果,包括实验室值和血液动力学参数.
主要方法:
- 95名患有ESS的感染性休克患者被分为低T3和低T3T4组.
- 患者随机分配,接受T3或安慰剂4天.
- 主要结局是28天生存期;次要结局包括实验室和血液动力学数据.
主要成果:
- 在低T3组中,T3补充增加了28天死亡率 (75%对33.3%,p=0.004).
- 在低T3T4组中,T3补充剂降低了ICU死亡率 (25%对52.1%,p=0.039).
- 在低T3T4组中,T3改善了平均动脉压,但在低T3组中没有改善.
结论:
- 三甲基氨酸 (T3) 补充与低T3T4 ESS的败血症休克患者的死亡率降低有关.
- 补充T3与患有低T3 ESS的患者的死亡率增加有关.
- 甲状腺激素补充剂在败血症患者的临床使用需要仔细考虑.
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