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报告了所检测66例肺炎患儿T_3、T_4、TSH、皮质醇变化,发现血清总T_4(TT_4:7.86±2.51nmol/L)、总T_3(TT_3<0.95±0.18nmol/L)明显低于健康对照组(TT_4<10.50±1.66nmol/L,TT_3<1.61±0.55nmol/L),有极显著性差异(P<0.01);血清TSH(4.86±1.90mIU/L)与健康对照组(4.74±0.99IU/L)比较无显著性差异(P>0.05)。低T_3和(或)低T_4者28例(42.42%),且以重症肺炎多见。重症肺炎患儿极期皮质醇(0.62±0.31μmol/L)高于健康对照组(0.47±0.16μmol/L)。本研究说明,重症肺炎患儿下丘脑垂体甲状腺轴存在获得性缺陷或暂时性功能低下,且T_3和(或)T_4显著降低者,提示预后不良;而下丘脑垂体肾上腺皮质轴功能正常,则能适应肺炎极期的应激变化,故治疗肺炎时应避免滥用大剂量激素。
The changes of T_3, T_4, TSH and Cortisol in 66 children with pneumonia were reported. The total serum T_4 (TT_4: 7.86 ± 2.51nmol / L) and total T_3 (TT_3 <0.95 ± 0.18nmol / L) (4.86 ± 1.90mIU / L) and control group (TT_4 <10.50 ± 1.66nmol / L, TT_3 <1.61 ± 0.55nmol / L) 0.99IU / L) was no significant difference (P> 0.05). 28 cases (42.42%) had low T 3 and / or low T 4, and were more common in severe pneumonia. The severity of cortisol in children with severe pneumonia (0.62 ± 0.31μmol / L) was higher than that in healthy controls (0.47 ± 0.16μmol / L). This study shows that children with severe pneumonia hypothalamic pituitary thyroid axis acquired defects or temporary dysfunction, and T_3 and (or) T_4 significantly decreased, suggesting that the prognosis is poor; and hypothalamic pituitary adrenal axis function is normal, then can Adapt to extreme stress changes in pneumonia, so the treatment of pneumonia should avoid abuse of large doses of hormones.