Influence of selenium supplements on the post-traumatic alterations of the thyroid axis:: a placebo-controlled trial
Influence of selenium supplements on the post-traumatic alterations of the thyroid axis:: a placebo-controlled trial
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DOI：
10.1007/s001340000757
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发表时间：
2001-01-01
影响因子：
38.9
通讯作者：
Chioléro, RL
中科院分区：
文献类型：
--
作者：
Berger, MM;Reymond, MJ;Chioléro, RL
目的：探讨早期补充硒是否可以改变创伤后甲状腺激素代谢的改变，因为创伤后第一周的特点是低血浆硒和负硒平衡。设计：前瞻性、安慰剂对照的随机补充试验。地点：某三级大学附属医院外科ICU。患者：31例创伤危重症患者，年龄42 +/- 16岁（平均+/- SD），多发严重损伤（损伤严重程度评分30 +/- 7）。干预：在损伤后的前5天补充硒或安慰剂。硒组进一步随机分配，每天接受500杯硒，加或不加150毫克α -生育酚（AT）和13毫克锌补充剂。安慰剂组接受载具。于D0（入院第0天）、D1、D2、D5、D10和D20测定循环硒、AT、锌和甲状腺激素。结果：硒组血浆Se， DO低，D1正常；D2后总T4、T3增加更快、增加更多（P = 0.04、0.08），D2与D0间逆T3增加更慢（P = 0.05）。结论：补充硒可提高循环硒水平。补充剂与甲状腺激素的适度变化有关，与T4和逆转T3血浆水平的早期正常化有关。AT和锌的加入没有产生任何额外的变化。
Objective:To investigate whether early selenium (Se) supplementation can modify the post-traumatic alterations of thyroid hormone metabolism, since the first week after trauma is characterised by low plasma Se and negative Se balances.Design: Prospective, placebo-controlled randomised supplementation trial.Setting: Surgical ICU in a tertiary university hospital.Patients: Thirty-one critically ill trauma patients aged 42 +/- 16 years (mean +/- SD), with severe multiple injury (Injury Severity Score 30 +/- 7).Intervention: Supplementation during the first 5 days after injury with either Se or placebo. The selenium group was further randomised to receive daily 500 mug Se, with or without 150 mg alpha -tocopherol (AT) and 13 mg zinc supplements. The placebo group received the vehicle. Circulating Se, AT, zinc, and thyroid hormones were determined on D0 (= day 0, admission), D1, D2, D5, D10, and D20.Results: Plasma Se, low on DO, normalised from D1 in the selenium group; total T4 and T3 increased more and faster after D2 (P = 0.04 and 0.08), reverse T3 rising less between D0 and D2 (P = 0.05).Conclusions: Selenium supplements increased the circulating Se levels. Supplementation was associated with modest changes in thyroid hormones, with an earlier normalisation of T4 and reverse T3 plasma levels. The addition of AT and zinc did not produce any additional change.