Endocrine changes in patients with acute organophosphate poisoning
Endocrine changes in patients with acute organophosphate poisoning
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DOI：
10.1191/096032799678839419
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发表时间：
1999-10-01
影响因子：
2.8
通讯作者：
Kelestimur, F
中科院分区：
文献类型：
--
作者：
G端ven, M;Bayram, F;Kelestimur, F
在危重病中，几种药物和各种应激条件改变神经递质的功能，从而影响垂体激素的分泌。虽然神经递质在内分泌系统调节中的作用已为人们所熟知，但胆碱能作用的研究较少。在动物中，胆碱酯酶抑制剂被证明可以改变垂体-甲状腺和垂体-肾上腺轴，并影响催乳素水平。本研究的目的是确定有机磷化合物对内分泌系统，特别是垂体激素的影响。这项前瞻性研究在Erciyes大学医学院医院的医学重症监护室进行。连续22例有机磷中毒患者（男10例，女12例，年龄28 ± 8岁），中毒期间ACTH（P < 0.002）、皮质醇（P < 0.0005）和PRL（P < 0.005）水平均显著高于中毒缓解后。中毒时血清FSH水平明显降低（P < 0.05），7例（31.8%）出现病态正常甲状腺综合征。其中2例fT（3）低（fT（4）和TSH正常），2例fT（3）低（fT（3）和TSH正常），3例TSH低（fT（3）和fT（4）正常）。这些激素的血清水平恢复到正常值后，解决中毒。本研究表明，有机磷化合物影响PRL、ACTH和皮质醇水平，但不影响LH水平，有机磷化合物可能导致病态甲状腺功能正常综合征，这些情况可能与乙酰胆碱的作用和有机磷化合物的直接作用有关。
In critical illness, several drugs and various stressful conditions modify the functions of neurotransmitters which consequently affect the secretion of pituitary hormones. Although the role of neurotransmitters in the regulation of endocrine system is well known, cholinergic actions have been less investigated. In animals, cholinesterase inhibitors were shown to modify the pituitary-thyroid and pituitary-adrenal axes, and to affect prolactin levels. The aim of the present study was to determine the effect of the organophosphate compounds on endocrine system, particularly pituitary hormones. This prospective study was performed in Medical Intensive Care Unit of Erciyes University Medical School Hospital. Twenty-two consecutive patients (ten males and 12 females aged 28 +/- 8 years) with organophosphate poisoning were included in the study, ACTH (P < 0.002), cortisol (P < 0.0005) and PRL (P < 0.005) levels were significantly higher during poisoning than after resolution of poisoning. FSH levels were significantly lower during poisoning (P < 0.05), Sick euthyroid syndrome was determined in seven patients (31.8%). Two of them had low fT(3) (with normal fT(4) and TSH), two had low fT(3) (with normal fT(3) and TSH) and three had low TSH (with normal fT(3) and fT(4)) levels. Serum levels of these hormones returned to normal values after resolution of poisoning. The present study demonstrated that organophosphate compounds affected PRL, ACTH and cortisol levels, but did not change LH levels, Organophosphate compounds may result in sick euthyroid syndrome, These conditions may be related to the effects of acetylcholine and direct effect of organophosphate compounds.