急性胰腺炎患者垂体-甲状腺轴的变化及意义

Significance of the Changes of Pituitary-Thyroid Axis Function in Patients with Acute Pancreatitis

目的 :探讨急性胰腺炎患者垂体 -甲状腺轴的功能变化及意义。方法 :用放射免疫分析 73例急性胰腺炎患者和 33例正常人血清T3 、FT3 、T4、FT4、rT3 、TSH水平 ,其中轻型急性胰腺炎 (mAP) 5 7例 ,重症急性胰腺炎 (sAP) 16例 ,并检测了其中 39例患者 (mAP2 8例 ,sAP11例 )恢复期血清上述激素水平。结果 :急性胰腺炎(mAP组和sAP组 )急性期T3 、FT3 、TSH显著低于正常 (p均 <0 0 5 ) ,rT3 升高 (p <0 0 1) ,恢复期T3 、FT3 虽有回升(与急性期比较p <0 0 1,0 0 5 ) ,但仍未恢复到正常水平 (与正常对照组比较p<0 0 1) ,rT3 恢复正常。mAP组急性期T4、FT4无异常改变 ,恢复期TSH接近正常 (p >0 0 5 ) ,sAP组急性期T4、FT4降低 ,与正常对照比较 (p <0 0 1) ,恢复期T4、FT4有所升高 (与急性期比较p<0 0 1) ,但均未达到正常水平 (p均 <0 0 1) ,同时发现mAP组T3 、FT3 、T4、FT4均高于sAP组 ,而rT3 、TSH两组无差异 (p >0 0 5 )。结论 :血清T3 、FT3 、T4、FT4水平可作为急性胰腺炎病情严重程度评估的一个指标。

Objective To investigate the clinical significance of changes of pituitary-thyroid axis function in patients with acute pancreatitis. Methods Serum levels of T 3? FT 3? T 4? FT 4? rT 3? TSH were measured with RIA in 73 patients with acute pancreatitis and 33 controls. Among them, 57 patients suffered from mild acute pancreatititis (mAP) with 16 suffered from severe acute pancreatitis (sAP). The serum hormone levels were determine for a second time in 39 patients (28 mAP, 11 sAP) during convalescence. Results The levels of T 3? FT 3? TSH in patients during acute period were significantly lower than those in controls ( p <0 05), but rT 3 level was higher ( p <0 01). Although the levels of T 3 and FT 3 rose back somewhat during recovery (vs acute stage: p <0 01, p <0 05) but were still below normal (vs controls: p <0 01). However, rT 3 level returned to normal again. The levels of T 4? FT 4 in mAP were normal in acute period and levels of TSH came back to normal during recovery (vs controls: ( p >0 05). The levels of T 4?FT 4 in SAP acute stage were significantly lower tham those in the controls ( p <0 01) and rose bacle somewhat during recovery (vs acute period: p <0 01) but still below normal (vs controls: p <0 01). Besides, levels of T 3?FT 3?T 4?FT 4 in mAP patients were significantly bigher than those in sAP group ( p <0 05,0 05,0 05,0 01). Howerver, rT 3?TSH levels in the two groups were about the same. Conclusion The levels of T 3?FT 3?T 4?FT 4 could be taken for apprasial of the severity of acute pancreatitis.