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目的:探讨皮质醇(COR)和促肾上腺皮质激素(ACTH)在危重症患者血清中的变化及及临床价值。方法:40例危重症患者(危重症组)和40例健康查体者(对照组)为研究对象,采用化学发光法测定血清COR和ACTH水平,计算游离皮质醇(FC)水平。并对COR的水平和ACTH的水平相关性分析。结果:危重症组患者血清COR、ACTH、FC水平显著高于对照组,相比较有显著性差异(P<0.05);MODS组患者血清COR、ACTH、FC水平显著高于非MODS组,相比较有显著性差异(P<0.05);危重症组患者COR水平和ACTH水平呈显著正相关性(r=0.5782,P=0.001)。结论:危重症患者血清COR、ACTH水平明显升高,且与病情危重程度相关,COR和ACTH可以做为判定危重症患者预后的可靠指标。
Objective: To investigate the changes and clinical value of serum cortisol (COR) and adrenocorticotropic hormone (ACTH) in the serum of critically ill patients. Methods: 40 critically ill patients (critically ill patients) and 40 healthy volunteers (control group) were selected as research objects. The levels of serum COR and ACTH were measured by chemiluminescence and the level of free cortisol (FC) was calculated. And the correlation between COR level and ACTH level was analyzed. Results: Serum levels of COR, ACTH and FC in critically ill patients were significantly higher than those in control group (P <0.05). The levels of COR, ACTH and FC in MODS patients were significantly higher than those in non-MODS patients (P <0.05). There was a significant positive correlation between COR level and ACTH level in critically ill patients (r = 0.5782, P = 0.001). CONCLUSIONS: Serum levels of COR and ACTH in critically ill patients are significantly increased, and are correlated with the severity of the disease. COR and ACTH can be used as reliable indicators to determine the prognosis of critically ill patients.