THYROID FUNCTION AND CARDIOPULMONARY BYPASS--A EUTHYROID SICK SYNDROME
甲状腺功能与心肺转流--甲状腺病态综合征
基本信息
- 批准号:3878981
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:
- 资助国家:美国
- 起止时间:至
- 项目状态:未结题
- 来源:
- 关键词:
项目摘要
The purpose of this prospective study was to define the effect of
cardiopulmonary bypass (CPBP) on thyroid function. Blood samples were
obtained from 14 patients the day of admission, postanesthetic induction,
post-heparination, following institution of CPBP, the nadir of hypothermia,
before termination of CPBP, and 2, 8, and 24 hrs postoperatively. TSH, TBG,
Total T-4, Total T-3 and reverse T-3 (rT-3), an inactive metabolite of T-4,
heretofore never reported with CPBP, were assayed by radioimmunoassay. Free
T-3 (ft-3) was assayed by equilibrium dialysis. Data were compared by
paired T-tests for all time intervals against preoperative values. Total
T-3 (T-3), the most active thyroid hormone, and fT-3 values were
significantly depressed (75 and 50% respectively) following CPBP for 24 hrs
(p<0.05). Reverse T-3 demonstrated a four-fold rise at 8 and 24 hrs
postoperatively (p<0.05), but no change at 2 hrs postoperatively. TBG was
decreased at all sampling time (p<0.)5). TSH, T-4 and fT-4 remained within
normal ranges at all sampling times. These results indicate that CPBP
simulates the "Euthyroid Sick Syndrome" as seen in severe burn and
critically ill patients. There was marked postoperative depression of T-3
and fT-3 with increased rT-3, while TSH, T-4 and fT-4 remained within
normal ranges. These data indicate utilization of fT-3 with concomitant
abnormal deiodination of T-4 to rT-3 or abnormal deiodination of rR-3 to T2
(the breakdown product of rT-3). It is concluded that CPBP produces a
blunted response of TSH to low T-3 and T-4. The deleterious hemodynamic
effects of hypothyroidism are well established. These data provide a basis
for intravenous administration of T-3 in the treatment of low cardiac
output syndrome following cardiopulmonary bypass.
这项前瞻性研究的目的是确定
体外循环(CPBP)对甲状腺功能的影响。血样
从14名患者入院当天,麻醉诱导后,
肝素化后,CPBP后,低温的最低点,
CPBP终止前、术后2、8、24 h。促甲状腺激素,总胆红素,
总T-4,总T-3和反向T-3(rT-3),T-4的无活性代谢产物,
用放射免疫分析法测定了迄今为止从未报道过的CPBP。免费
平衡透析法测定T-3(ft-3)。数据比较
所有时间间隔与术前值的配对T检验。总
最活跃的甲状腺激素T-3(T-3)和fT-3值分别为
CPBP 24小时后显著降低(分别为75%和50%)
(p<0.05)。反向T-3在8小时和24小时显示出四倍的升高
术后2小时无明显变化。TBG是
在所有采样时间均降低(p<0.)5)。TSH、T-4和fT-4保持在范围内
所有采样时间的正常范围。这些结果表明,CPBP
模拟严重烧伤中所见的“正常甲状腺病态综合征”,
危重病人。术后T-3明显降低
而TSH、T-4和fT-4保持在
正常范围。这些数据表明使用fT-3伴随
T-4异常脱碘为rT-3或rR-3异常脱碘为T2
(the rT-3的分解产物)。结果表明,CPBP产生的
TSH对低T-3和T-4的反应迟钝。有害的血液动力学
甲状腺功能减退症的影响是众所周知的。这些数据提供了一个基础
用于静脉内施用T-3治疗低心脏病
心肺转流术后输出综合征。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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{{ truncateString('R E CLARK', 18)}}的其他基金
MITRAL VALVE REPLACEMENT WITH AND WITHOUT CHORDAL EXCISION
带或不带索状切除的二尖瓣置换术
- 批准号:
4694596 - 财政年份:
- 资助金额:
-- - 项目类别:
MITRAL VALVE REPLACEMENT WITH AND WITHOUT CHORDAL EXCISION
带或不带索状切除的二尖瓣置换术
- 批准号:
3966638 - 财政年份:
- 资助金额:
-- - 项目类别:
USE OF FENOLDOPAM IN POSTCARDIOTOMY LOW OUTPUT SYNDROME
非诺多泮在心脏切开术后低输出量综合征中的应用
- 批准号:
3942870 - 财政年份:
- 资助金额:
-- - 项目类别:
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