目的：了解天津滨海危险品爆炸后受伤消防战士甲状腺激素水平的变化情况，探讨甲状腺激素与应激的关系。方法采用美国强生vitros3600进行电化学检测消防战士受伤前后各个时段总三碘甲状腺原氨酸（total-triiodothyronine， TT3）、总甲状腺素（thyroxine，TT4）、游离三碘甲状腺原氨酸（three free iodine thyroid former glycine，FT3）、游离甲状腺素（free thyroxine，FT4）及促甲状腺素（thyroid stimulating hormone，TSH）的水平。结果对消防战士受伤前后各时间点血清甲状腺激素水平进行整体比较，结果显示，各时间点之间TT3（F=85.95，P<0.05）、TT4（F=27.98，P<0.05）、FT3（F=14.89，P=0.001）、FT4（F=11.96，P<0.05）差异均有统计学意义；TSH差异无统计学意义（F=1.99，P=0.164）。消防战士受伤时甲状腺各激素的变化率排序为TSH>TT3>FT4>TT4>FT3，受伤24 h的变化率排序为TSH>FT4>FT3>TT3>TT4，受伤48 h变化率排序为TSH>TT4>FT3>FT4>TT3。结论甲状腺激素参与消防战士受伤后机体应激反应，TT3、TT4、FT3、FT4可以作为外伤应激反应的指标。%Objective The aim of this study was to investigate the variation of serum thyroid hormone levels in fire fighters injured in the explosion on 8·12 in Tianjin, and to explore the relationship between the thyroid hormone and stress. Methods Total-triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels of fire fighters before and after injury were analyzed with an immunology analyzer, Johnson Vitros 3600 from America. Results Serum thyroid hormone levels of fire fighters before and after injury as well as at different time points were compared. The results showed statistically significant differences across all time points in TT3 (F=85.95, P<0.05), TT4 (F=27.98, P<0.05), FT3 (F=14.89, P=0.001), FT4 (F=11.96, P<0.05);but the difference in TSH was not significant (F=1.99, P=0.164). The order of degree of variation of the fire fighters' thyroid hormone levels soon after injury was sorted as TSH>T3>FT4>T4>FT3, 24 h after injury it was TSH>FT4>FT3>T3>T4, and TSH>T4>FT3>FT4>T3 48 h after injury. Conclusions Thyroid hormones are involved in the stress response of injured fire fighters, and TT3, TT4, FT3, FT4 can be used as indicators of trauma stress response.
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