甲状腺素在脑死亡患者肝肾功能维护中的作用

发布时间：2018-02-26 03:23

本文关键词： 脑死亡甲状腺素器官功能维护　出处：《广东医学》2017年14期 　论文类型：期刊论文

【摘要】：目的回顾分析脑死亡患者不同时机的甲状腺素治疗,并探讨甲状腺素对血压和器官功能的影响。方法对收治和转入的137例脑死亡患者按甲状腺素治疗时机分为3组:对照组43例,只给予常规治疗;预防组52例,除常规治疗外,入组时即给予甲状腺素片50μg/d;补充组42例,除常规治疗外,在测定发现甲状腺素水平低下后补充甲状腺素片50μg/d。对比分析各组低T3、T4发生率、低血压发生率、血管活性药用量和肝肾功能等。结果入组后20 d内,预防组低甲状腺素水平和低血压发生率低于其他两组,补充组低于对照组,差异有统计学意义(P0.05);平均多巴胺和去甲肾上腺素用量补充组低于对照组,预防组低于其他两组,差异有统计学意义(P0.05);联合用药率和肝肾功能异常率预防组低于其他两组,补充组肝肾功能损伤发生率低于对照组,预防组低于其他两组,差异有统计学意义(P0.05)。结论甲状腺素片可以降低脑死亡患者的低甲状腺素水平和低血压发生率,减少血管活性药用量,并进一步降低肝肾功能损伤率,且预防效果优于补充治疗。
[Abstract]:Objective to retrospectively analyze the thyroxine therapy in patients with brain death at different time. Methods 137 patients with brain death were divided into 3 groups according to the time of thyroxine therapy: the control group (43 cases) was given routine therapy, the prevention group (52 cases), except routine treatment. Thyroxine tablets were given 50 渭 g / d in the group and 42 cases in the supplement group, in addition to routine treatment, were given 50 渭 g / d thyroxine tablets after the determination of hypothyroxine level. The incidence of hypothyroidism T4 and hypotension in each group were compared and analyzed. Results the level of hypothyroidism and the incidence of hypotension in the prevention group were lower than those in the other two groups, and those in the supplement group were lower than those in the control group. The average dosage of dopamine and norepinephrine in the control group was lower than that in the control group, and that in the prevention group was lower than that in the other two groups, the difference was statistically significant (P 0.05), the combined drug use rate and the abnormal rate of liver and kidney function in the prevention group were lower than those in the other two groups. The incidence of liver and kidney function injury in the supplement group was lower than that in the control group and that in the prevention group was lower than that in the other two groups (P 0.05). Conclusion Thyroxine tablets can reduce the level of hypothyroxine and the incidence of hypotension in the patients with brain death. The dosage of vasoactive drugs was reduced, the rate of liver and kidney function injury was further reduced, and the preventive effect was better than that of supplementary therapy.
【作者单位】：中山大学附属第一医院急诊科;广州军区总医院供应科;
【基金】：广东省自然科学基金资助项目(编号:S2013010015328)
【分类号】：R651.1

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