Relationship Between Heart Rate Variability And Thyroid Hormones In Patients With Sepsis And Its Value

Objective To investigate the relationship between heart reat variability and thyroid hormones in patients with spsis and its value in judging the severity of the disease.Methods54patients admitted to the Emergency Medicine ward of Tianjin Medical University General Hospital from January2013to June2013were selected as sepsis group,and another26non-sepsis patients from the same period were selected as control group. The patients were divided either into survival group(36cases) and death group(18cases) according to prognosis outcome,or according to the FT3valus,low FT3group(33cases) and normal FT3group(21cases).we compared the HRV,thyroid hormones,cortisol,lactate,and other observation indicators between the sepsis group and control group,survival group and death group,low FT3group and normal FT3group.ROC was drawn and the area under ROC curve was calculated. Analyse the relationship between Heart Rate Variability and Thyroid Hormones in patients with sepsis and its value.Results (1) The SDNN, SDANN, PNN50, RMSSD, LAC,FT3,FT4, COR, GLU between sepsis group and control group showed statistically significant differences(P<0.05),but the PLT showed no statistically significant difference(P>0.05).(2)The SDNN,SDANN,PNN50,APACHEII score,LAC,FT3,FT4,COR,GLU between death group and survival group showed statistically significant differences(P<0.05),but the RMSSD and PLT showed no statistically significant difference(P>0.05).(3)The SDNN,SDANN,PNN50,APACHE Ⅱscore,LAC,FT3,FT4,COR,GLU between low FT3group and normal FT3group showed statistically significant differences(P<0.05),but the PLT showed no statistically significant difference(P>0.05).(4) Spearman’s correlation analysis showed that the APACHE Ⅱ score of septic patients was negatively correlated with SDNN,SDANN,FT3,FT4(r=-0.474,-0.447.-0.762,-0.682;P<0.05),but was positively correlated with LAC,COR,GLU(r=0.627,0.561,0.700;P<0.01). (5)ROC curve of prognostic factors in patients with sepsis showed the AUC for SDNN was0.948,FT3had the laggest AUC Of0.961.Both had a high sensitivity and specificity.Conclusion the early manifestations of sepsis are low levels of FT3and FT4, and patients with decrease in HRV usually have bad prognosis. HRV measures and Thyroid Hormones testes,especially the SDNN and FT3, are of good value for the prediction of sepsis severity and prognosis.