Dulchavsky S A, Bailey J
Department of Surgery, Wayne State University School of Medicine, Detroit, Mich.
Surgery. 1992 Aug;112(2):475-9.
Pulmonary compromise with altered surfactant metabolism is frequently noted during sepsis; triiodothyronine is necessary for normal surfactant synthesis. We evaluated the role of physiologic replacement of triiodothyronine during sepsis-induced hypothyroidism on surfactant synthesis and lung structural integrity.
Male Sprague Dawley rats (average weight, 330 gm) underwent sham laparotomy or cecal ligation and puncture; treatment was administered to rats that underwent cecal ligation and puncture by Alzet osmotic pump consisting of triiodothyronine (3 ng/hr) or saline control. The rats were killed 24 hours after serum triiodothyronine determination by radioimmunoassay (normal, 60 to 160 ng/dl). Surfactant was obtained by saline lavage. Lipid content was determined by Folch extraction; phospholipid content was verified by chromatography. Blinded histologic analysis of lung confluence and alveolar sparing was done in separate subgroups. Results are +/- SE.
Control rats with sepsis were hypothyroid at 24 hours; rats given triiodothyronine were euthyroid (rats that underwent sham laparotomy, 67.7 +/- 4.9 ng/dl; control rats, 37.6 +/- 5.7 ng/dl; and triiodothyronine, 85.7 +/- 19 ng/dl; p less than 0.05 compared with triiodothyronine by analysis of variance). Surfactant production was significantly improved by triiodothyronine compared with control (60.7 +/- 22.6 mg vs 23.2 +/- 11.3 mg; p less than 0.05 by analysis of variance). Lung histologic integrity was maintained by triiodothyronine treatment during sepsis.
Triiodothyronine supplementation may be beneficial in septic-induced pulmonary dysfunction.
脓毒症期间常出现肺功能受损且表面活性剂代谢改变；三碘甲状腺原氨酸是正常表面活性剂合成所必需的。我们评估了脓毒症诱导的甲状腺功能减退期间生理剂量补充三碘甲状腺原氨酸对表面活性剂合成和肺结构完整性的作用。
雄性Sprague Dawley大鼠（平均体重330克）接受假手术或盲肠结扎穿刺术；通过Alzet渗透泵对接受盲肠结扎穿刺术的大鼠进行治疗，渗透泵包含三碘甲状腺原氨酸（3纳克/小时）或生理盐水对照。通过放射免疫测定法测定血清三碘甲状腺原氨酸（正常范围为60至160纳克/分升）24小时后处死大鼠。通过盐水灌洗获取表面活性剂。通过Folch提取法测定脂质含量；通过色谱法验证磷脂含量。对不同亚组进行肺融合和肺泡保留的盲法组织学分析。结果以平均值±标准误表示。
脓毒症对照组大鼠在24小时时甲状腺功能减退；给予三碘甲状腺原氨酸的大鼠甲状腺功能正常（接受假手术的大鼠，67.7±4.9纳克/分升；对照大鼠，37.6±5.7纳克/分升；三碘甲状腺原氨酸组，85.7±19纳克/分升；方差分析显示与三碘甲状腺原氨酸组相比p<0.05）。与对照组相比，三碘甲状腺原氨酸显著改善了表面活性剂的产生（60.7±22.6毫克对23.2±11.3毫克；方差分析显示p<0.05）。脓毒症期间三碘甲状腺原氨酸治疗维持了肺组织学完整性。
补充三碘甲状腺原氨酸可能对脓毒症诱导的肺功能障碍有益。
