游离三碘甲状腺原氨酸降低对感染诱发的老年多器官功能障碍综合征的早期预测价值

Early predictive value of decrease in free triiodothyronine for infection-induced multiple organ dysfunction syndrome in the elderly

【摘要】目的 探讨游离三碘甲状腺原氨酸(FT3)降低对感染诱发的老年多器官功能障碍综合征(i-MODSE)是否具有早期预测作用。方法 回顾性分析2017年1月至2021年12月于空军军医大学第一附属医院老年病科出院的755例老年(≥65岁)感染患者的临床资料,根据住院期间是否发生多器官功能障碍综合征(MODS)将患者分为MODS组(n=80)和对照组(n=675),分析人口学特征和包括FT3在内的实验室检查结果对i-MODSE的影响。采用SPSS 26.0统计软件进行数据分析。根据数据类型,分别采用t检验、Mann-Whitney U检验或χ²检验进行组间比较。采用二元logistic回归分析i-MODSE发生的影响因素。结果 755例患者中,MODS发生率为10.60%(80/755)。与对照组相比,MODS组FT3显著降低[(2.67±0.87)和(3.40±0.79)pmol/L；P<0.001]。logistic回归分析结果显示,FT3降低是老年感染患者MODS发生的独立危险因素(OR=4.748,95%CI 2.387~9.443；P<0.001)。结论 FT3降低是老年感染患者MODS发生的独立危险因素,可以应用于早期预测i-MODSE。

基金项目:西京医院学科助推计划(XJZT18MDT11,XJZT21L15)

【Abstract】Objective To explore whether the decrease of free triiodothyronine (FT3) has early predictive value in infection-induced multiple organ dysfunction syndrome in the elderly (i-MODSE). Methods The clinical data of 755 elderly infected patients (≥65 years old) who were discharged from the Department of Geriatrics, First Affiliated Hospital of Air Force Military Medical University from January 2017 to December 2021 were retrospectively analyzed. According to the occurrence of multiple organ dysfunction syndrome (MODS) during hospitalization, the patients were divided into MODS group (n=80) and control group (n=675). The effects of demographic characteristics and laboratory tests, including FT3, on i-MODSE were analyzed. The data were analyzed by SPSS statistics 26.0. Data comparison between two groups was performed using student′s t test, Mann-Whitney U test or Chi-square test depending on different data types. Binary logistic regression was used to analyze the influencing factors of i-MODSE. Results Among the 755 patients, the incidence of MODS was 10.60% (80/755). FT3 level was significantly lower in the MODS group than the control group [(2.67±0.87) vs (3.40±0.79) pmol/L; P<0.001]. Logistic regression analysis showed that FT3 decline was an independent risk factor for the occurrence of MODS in elderly infected patients (OR=4.748,95%CI 2.387-9.443; P<0.001). Conclusion FT3 decline is an independent risk factor for the occurrence of MODS in elderly patients with infection, and can be used to predict i-MODSE in the early stage.

This work was supported by the Discipline Promotion Plan of Xijing Hospital(XJZT18MDT11, XJZT21L15).