90岁及以上高龄住院患者甲状腺功能的相关研究

发布时间：2018-02-06 02:01

本文关键词： 高龄老年人正常甲状腺功能病态综合征甲状腺功能减退亚临床甲状腺功能减退　出处：《上海交通大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的研究90岁及以上高龄老年住院患者甲状腺功能异常的发病率,探讨不同甲状腺功能状态的老年患者常见的合并疾病、代谢营养状况及异常甲状腺功能状态对患者死亡率的影响,以提高对高龄老年患者甲状腺功能状态对疾病转归影响的认识。方法收集2010年1月1日至2014年12月31日在瑞金医院老年病科住院的90岁及以上的老年患者204人临床资料,对其基本信息、甲状腺功能及相关实验室检查数据以及既往疾病史做统计分析。记录截止至2014年12月31日死亡病例及其死亡原因。将入选患者根据甲状腺功能分组,及是否死亡分组,分别进行分析比较。结果所有204名患者中甲状腺功能异常者88人(43.1%),其中ESS的69人(33.8%),甲减及亚甲减共16人(7.8%),亚甲亢者3人(1.5%),无甲亢病人;ESS组在营养状况相关指标上低于甲功正常组,甲减及亚甲减组的患者甘油三酯高于甲功正常组,死亡率比较时发现ESS组死亡率是明显高于甲功正常组的(P=0.003)。Enter法回归分析时发现FT4升高时,死亡的风险增加,另外Logistic逐步回归分析发现FT3及血清白蛋白是与死亡相关的独立预测因子。结论90岁以上高龄老人甲状腺功能异常发病率高,并且ESS最多,而其中低T3又是占最大比例的,低T3的发生往往意味着预后不良。ESS实验室指标的异常主要表现在营养相关指标上,而甲减及亚甲减组则是表现在代谢相关指标上。甲状腺功能的异常与死亡的风险密切相关,T3与FT3的降低意味着死亡风险的增加,而FT4与之相反,血清FT3及白蛋白水平是与甲状腺功能异常患者死亡相关的预测因子。
[Abstract]:Objective to study the incidence of thyroid dysfunction in elderly patients aged 90 years and over, and to explore the common complicated diseases in elderly patients with different thyroid function status. The effect of metabolic nutritional status and abnormal thyroid function on the mortality of patients. Methods from January 1st 2010 to December 31st 2014, 90 years old hospitalized in the geriatric department of Ruijin Hospital were collected. Clinical data of 204 elderly patients. About its basic information. The data of thyroid function and related laboratory examination as well as the history of previous diseases were statistically analyzed. Cases of death and the causes of death were recorded as of December 31st 2014. Patients will be grouped according to thyroid function. Results there were 88 patients with abnormal thyroid function and 43.1 patients with abnormal thyroid function, including 69 patients with ESS (33. 8%). There were 16 patients with hypothyroidism and subhypothyroidism, and 3 patients with hyperthyroidism were found to have no hyperthyroidism. The relative nutritional status in ESS group was lower than that in normal group, and triglyceride in hypothyroidism and hypothyroidism group was higher than that in normal group. The mortality rate in ESS group was significantly higher than that in normal A group. The risk of death was increased when FT4 was increased in the regression analysis of P0. 003U. Enter. In addition, Logistic stepwise regression analysis showed that FT3 and serum albumin were independent predictors of mortality. Conclusion the incidence of thyroid dysfunction in the elderly over 90 years old is high. And ESS is the most, and low T3 is the largest proportion, the occurrence of low T3 often means poor prognosis. Abnormal laboratory indicators of ESS are mainly related to nutrition indicators. In hypothyroidism and subhypothyroidism groups, the metabolic related indexes were found. The abnormal thyroid function was closely related to the risk of death. The decrease of T3 and FT3 meant an increase in the risk of death, whereas FT4 was the opposite. Serum FT3 and albumin levels are the predictors of death in patients with abnormal thyroid function.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581

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