Early changes in function of hypothalamic-pituitary-target gland axis in patients with severe sepsis and septic shock
OBJECTIVE: To investigate the early changes in function of hypothalamic-pituitary-target gland (HPTG) axis in patients with severe sepsis and septic shock, in order to clarify its relationship with severity and prognosis of the patients
Veröffentlicht in: | Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue. - 1998. - 19(2007), 6 vom: 18. Juni, Seite 332-5 |
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1. Verfasser: | |
Weitere Verfasser: | , , , , , , |
Format: | Aufsatz |
Sprache: | Chinese |
Veröffentlicht: |
2007
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Zugriff auf das übergeordnete Werk: | Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue |
Schlagworte: | English Abstract Journal Article Research Support, Non-U.S. Gov't Hormones |
Zusammenfassung: | OBJECTIVE: To investigate the early changes in function of hypothalamic-pituitary-target gland (HPTG) axis in patients with severe sepsis and septic shock, in order to clarify its relationship with severity and prognosis of the patients METHODS: The serum contents of cortisol (F), triiodothyronine (T(3)), thyroxine (T(4)), thyrotropic-stimulating hormone (TSH), growth hormone (GH), follicle-stimulating hormone (FSH), luteotropic hormone (LH), prolactin (PRL) and plasma concentration of adrenocorticotrophic hormone (ACTH) in 10 severe sepsis and 12 septic shock patients on day 1, 3, 5 after diagnosis was made, and 12 patients with no infection or septic shock served as controls. The hypothalamic-pituitary adrenal gland axis (HPAA) function of the patients with severe sepsis and septic shock were evaluated with 1 microgram ACTH stimulation test given 1 day after the concentrations of the above hormones were determined RESULTS: Compared with the control patients, ACTH, T(3), T(4), GH, FSH, LH and PRL levels were significantly changed in patients with severe sepsis and septic shock (P<0.05 or P<0.01). The numbers of patients with reaction to 1 microgram ACTH stimulation test were similar between patients with severe sepsis (6 cases non-reaction and 3 cases reaction) and patients with septic shock (9 cases non reaction and 2 cases reaction, P>0.05). According to the acute physiology and chronic health evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) score, changes in ACTH, T(3), T(4), GH and PRL levels were closely related to the severity of illness (P<0.05 or P<0.01). Significant differences were found in ACTH, T(3), T(4) levels between survivors and non-survivors (P<0.05 or P<0.01). ACTH, T(4) levels and SOFA score were independent predictors of the 28-day hospital mortality (P<0.05 or P<0.01) CONCLUSION: The early changes in HPTG axis are closely related with the severity and hospital mortality in patients with severe sepsis and septic shock |
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Beschreibung: | Date Completed 09.07.2009 Date Revised 11.03.2022 published: Print Citation Status MEDLINE |
ISSN: | 1003-0603 |