CAJ | 학술논문

目的观察应激状态下甲状腺功能及相关炎症因子的变化规律,分析非甲状腺性的病态综合征(NTIS)时甲状腺功能及炎症因子的变化与疾病转归的关系.方法30只家兔随机取24只用55%氢氟酸烧伤5%体表面积.伤前5min,伤后2、8、24、72、168、336h 分别采集静脉血3ml,采用化学发光法检测游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)和促甲状腺素(TSH),ELISA 方法检测血清热休克蛋白(HSP)、TNF-α、IL-6.结果(1)家兔烧伤应激后于24h 内死亡5只,死亡率为20.8%,之后分别于48、72h 各死亡2只,总死亡率37.5%.与对照组比较,烧伤应激后的存活组家兔的 FT3于伤后8h 下降显著(P<0.05), FT4、TSH 于伤后24h 下降显著(P<0.05),FT3、FT4、TSH 均于24h 达最低点(P<0.05),随后血 FT3、FT4、TSH 浓度水平逐步升高,于伤后168h 基本升至伤前水平,与伤前相比无统计学差异(P >0.05).(2)与正常对照组比较,烧伤应激后的存活组家兔的 HSP、TNF-α均在8~24h 升至平台期(P<0.05),之后逐渐恢复正常,早于甲状腺功能的变化,IL-6也在8h 达高峰,但是峰值变化更大(P<0.01),持续时间更久.(3)死亡组与存活组比较,甲状腺功能变化有统计学差异(P<0.05),HSP、TNF-α、IL-6均明显增高(P<0.05),其中IL-6变化更大(P<0.01).结论家兔皮肤烧伤后甲状腺功能随病程的延长呈现规律变化,24h 内甲状腺功能达最低水平,之后逐渐自行恢复,呈“U”型曲线变化,与炎症因子 HSP、TNF-α、IL-6变化相关.
목적관찰응격상태하갑상선공능급상관염증인자적변화규률,분석비갑상선성적병태종합정(NTIS)시갑상선공능급염증인자적변화여질병전귀적관계.방법30지가토수궤취24지용55%경불산소상5%체표면적.상전5min,상후2、8、24、72、168、336h 분별채집정맥혈3ml,채용화학발광법검측유리삼전갑상선원안산(FT3)、유리사전갑상선원안산(FT4)화촉갑상선소(TSH),ELISA 방법검측혈청열휴극단백(HSP)、TNF-α、IL-6.결과(1)가토소상응격후우24h 내사망5지,사망솔위20.8%,지후분별우48、72h 각사망2지,총사망솔37.5%.여대조조비교,소상응격후적존활조가토적 FT3우상후8h 하강현저(P<0.05), FT4、TSH 우상후24h 하강현저(P<0.05),FT3、FT4、TSH 균우24h 체최저점(P<0.05),수후혈 FT3、FT4、TSH 농도수평축보승고,우상후168h 기본승지상전수평,여상전상비무통계학차이(P >0.05).(2)여정상대조조비교,소상응격후적존활조가토적 HSP、TNF-α균재8~24h 승지평태기(P<0.05),지후축점회복정상,조우갑상선공능적변화,IL-6야재8h 체고봉,단시봉치변화경대(P<0.01),지속시간경구.(3)사망조여존활조비교,갑상선공능변화유통계학차이(P<0.05),HSP、TNF-α、IL-6균명현증고(P<0.05),기중IL-6변화경대(P<0.01).결론가토피부소상후갑상선공능수병정적연장정현규률변화,24h 내갑상선공능체최저수평,지후축점자행회복,정“U”형곡선변화,여염증인자 HSP、TNF-α、IL-6변화상관.
Objective To investigate the change of thyroid function and inflammatory cytokines in stress status, to provide pathophysiological foundation of nonthyroidal il ness syndrome (NTIS). Methods The 5% body surface area was burned with 55% hydrofluoric acid in 24 rabbits. The venous blood samples were collected on 5 min before and 2, 8, 24, 72, 168, 336h after the injury. Free tri odothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) were detected by chemiluminescence method, and the heat shock protein (HSP), tumor necrosis factor (TNF-α), interleukin 6 (IL-6) were detected by ELISA method. Results Five rabbits died in 24 h, 2 died in 48 h and another 2 died in 72 h with the total mortality rate of 37.5%. The FT3 level of the alive group declined significantly in 8h (P<0.05), the FT4, TSH levels reached lowest points in 24h, then the FT3, FT4 and TSH level began to rise gradual y and returned to the baseline levels after 168h (P >0.05). HSP, TNF-α and IL-6 changed earlier than the thyroid function. The platform period of HSP, TNF-α and IL-6 of the alive group appeared in 8-24 h, then returned to the normal level gradual y (P<0.05). IL-6 reached peak level at 8h, the changed markedly and lasted longer (P<0.01). The thyroid function be-tween the fatal group and the alive group had significant differences (P<0.05). The changes of HSP, TNF-α and IL-6 in the fatal group were more prominently compared to the alive group (P<0.05), especial y for IL-6 (P<0.01). Conclusion The thyroid function in rabbits under burn stress presents U-shaped changes, which are correlated with the levels of inflammatory cytokines.