Interleukin-6 and thyroid hormone metabolism in pediatric cardiac surgery patients.
Interleukin-6 and thyroid hormone metabolism in pediatric cardiac surgery patients.
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小儿心脏手术患者的白细胞介素 6 和甲状腺激素代谢。
DOI：
10.1089/105072503321582123
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Ojamaa,Kaie
中科院分区：
文献类型：
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作者：
McMahon,ClarieK;Klein,Irwin;Ojamaa,Kaie
据报道，接受心脏手术的儿科患者术后血清三碘甲状腺原氨酸（T3）水平较低。这种功能障碍的原因尚不清楚，尽管 促炎细胞因子如白细胞介素-6（IL-6）与甲状腺素（T4）向T3的肝转化的抑制有关。本研究测定了IL-6的血清水平， 16例（平均年龄28 ± 7 d）体外循环手术患儿术后4d内T_3、T_4、T_6、T_7、T_8、T_9、T_10、T_11、T_12、T_11、T_13、T_11、T_12、T_1平均术前血清总T3水平为 164 ± 30 ng/dL（2.5 ± 0.5 nmol/L），在术后48小时内显著降至最低值43 ± 8 ng/dL（0.6 ± 0.01 nmol/L）。血清IL-6水平显著升高 从术前16 ± 7 pg/mL到术后2-3小时测量的峰值374 ± 134 pg/mL。血清中的峰值浓度与血清中的峰值浓度呈正相关（r ~ 2 = 0.507）， 术后4天IL-6水平和血清T3水平均降至最低。潜在的治疗针对减少促炎细胞因子的上升， 术后即刻应用可有效预防心脏手术患儿血清T3水平降低，从而降低术后并发症。
Pediatric patients undergoing cardiac surgery have been reported to have low serum triiodothyronine (T3) levels in the postoperative period. The cause of this dysfunction is not known, although proinflammatory cytokines such as interleukin-6 (IL-6) have been implicated in the inhibition of hepatic conversion of thyroxine (T4) to T3. This study measured serum levels of IL-6 and T3during the first 4 postoperative days in 16 children (mean age, 28 ± 7 days) undergoing cardiopulmonary bypass surgery. The mean preoperative serum total T3level was 164 ± 30 ng/dL (2.5 ± 0.5 nmol/L) that decreased significantly to a nadir of 43 ± 8 ng/dL (0.6 ± 0.01 nmol/L) within 48 hours after surgery. Serum IL-6 levels increased significantly from 16 ± 7 pg/mL preoperatively to a peak value of 374 ± 134 pg/mL measured 2-3 hours after surgery. A positive correlation (r2= 0.507) was found between the peak serum level of IL-6 and the lowest serum T3level in each patient attained during the 4 postoperative days. Potential treatments directed toward diminishing the rise in proinflammatory cytokines in the immediate postoperative period may prove effective in preventing the low serum T3in children undergoing cardiac surgery, and thus diminish the associated postoperative morbidity.