Sepsis hastalarının klinik sonuçları ile tiroid fonksiyon testleri arasındaki ilişkinin belirlenmesinde yeni bir belirteç: serbest triiyodotironinin serbest tiroksin oranı

Year 2023, Volume: 48 Issue: 3, 1106 - 1114, 30.09.2023

Esra Yakışık , Çiğdem Yücel , Murat Kızılgün , Işıl Özkoçak Turan

https://doi.org/10.17826/cumj.1310083

Cited By: 1

Abstract

Amaç: Çalışmamızda septik hastalarda tiroid hormonlarının prediktif değerini araştırdık.
Gereç ve Yöntem: Çalışmamız yoğun bakım ünitesinde (YBÜ) yatan sepsis hastalarında yapıldı. Hastaneye yatış anında ve 48. saatte alınan serbest triiodotironin (sT3) ve serbest tiroksin (sT4) düzeyleri ölçüldü ve sT3/sT4 oranı hesaplandı. Birinci ve 48. saatler arasındaki sT3 ve sT4, değişikliği hesaplandı.
Bulgular: Çalışmaya 192 sepsis hastası dahil edildi. Kaybedilen hastalarda birinci sT3 (1.60±0.57 ng/dL vs 2.01±0.41 ng/dL) ve sT3/sT4 oranı (1.34±0.88 vs 1.79±0.91), 48. saatteki sT3 (0.77±0.39 ng/dL vs 1.87±0.49 ng/dL) ve sT3/sT4 oranından (0.60±0.51 vs 1.66±1.21) yaşayanlara göre anlamlı olarak düşük bulundu. İlk sT3 düzeylerinin (-0.83±0.45 vs -0.23±0.14) ve sT3/sT4 oranının 48. saatte (-0.73±0.62 vs -0.12±0.11) kaybedilenlerde yaşayanlarda göre anlamlı olarak daha fazla azaldığı saptandı. 48. saat sT3 düzeyi ve ilk ile 48. saat arasındaki sT3 değişiminin mortalite göstergesi için en anlamlı parametreler olduğu bulundu.
Sonuç: sT3/sT4 oranının YBÜ’deki sepsisli hastalarda mortalite için prediktif değere sahip olduğu gösterilmiştir. Ayrıca hem yatışta hem de 48. saatteki sT3 değerleri mortalite için anlamlı öngörücü göstergeler olduğu bulundu.

Keywords

Serbest triiyodotironin/serbest tiroksin oranı, Yoğun bakım ünitesi, Sepsis, Tiroksin, Triiyodotironin

Supporting Institution

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Project Number

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Thanks

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A new marker in determining the relationship between the clinical outcomes of patients with sepsis and thyroid function tests: free triiodothyronine to free thyroxine ratio

Abstract

Purpose: This study investigated the predictive value of thyroid hormones in septic patients.
Materials and Methods: Our study was conducted in patients with sepsis in intensive care unit (ICU). Free triiodothyronine (fT3) and free thyroxine (fT4) levels taken at the time of hospitalization and at the 48th hours were measured and the fT3 / fT4 ratio was calculated. Calculated fT3 and fT4 change between first and 48th hours.
Results: 192 patients with sepsis were included in the study. In non-survivor patients, first fT3 (1.60±0.57 ng/dL v.s. 2.01±0.41 ng/dL) and fT3 / fT4 ratio (1.34±0.88 v.s. 1.79±0.91) were found to be significantly lower than 48th hours fT3 (0.77±0.39 ng/dL v.s. 1.87±0.49 ng/dL) and fT3 / fT4 ratio (0.60±0.51 v.s. 1.66±1.21) survivors. It was found that the first fT3 levels (-0.83±0.45 v.s. -0.23±0.14) and fT3 / fT4 ratio (-0.73±0.62 v.s. -0.12±0.11) decreased significantly more at 48th hour in non-survivors than survivors. The 48th hours fT3 level and the change in fT3 between the first and 48th hour were found to be the most significant parameters for the mortality indicator.
Conclusion: fT3 / fT4 ratio has predictive value for mortality in patients with sepsis in ICU. In addition, fT3 was found to be an indicator for mortality predictivity both at admission and at 48th hours.

Keywords

Free triiodothyronine/free thyroxine ratio, Intensive care unit, Sepsis, Thyroxine, Triiodothyronine

Project Number

yok

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