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在使用抗惊厥药物治疗前,患有特发性癫痫的犬的甲状腺功能正常病态综合征。

Euthyroid sick syndrome in dogs with idiopathic epilepsy before treatment with anticonvulsant drugs.

作者信息

von Klopmann Thilo, Boettcher Irene Christine, Rotermund Annett, Rohn Karl, Tipold Andrea

机构信息

Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany.

出版信息

J Vet Intern Med. 2006 May-Jun;20(3):516-22. doi: 10.1892/0891-6640(2006)20[516:essidw]2.0.co;2.

Abstract

Euthyroid sick syndrome is a common finding in dogs and is attributable to nonthyroidal illness or treatment with any of a variety of drugs such as phenobarbital. In dogs with epilepsy, treatment with anticonvulsant drugs can lead to subnormal plasma thyroid hormone concentrations despite normal thyroid function. One-hundred thirteen dogs with seizure activity were retrospectively evaluated to determine the influence of idiopathic epilepsy (IE) on thyroid hormone concentrations. Blood samples were taken from 60 dogs with IE before initiation of anticonvulsant therapy. Control groups consisted of 34 dogs with IE and receiving anticonvulsants and 19 dogs with secondary epilepsy. Thyroid concentrations consistent with euthyroid sick syndrome were diagnosed in 38% of dogs with untreated IE without clinical signs of hypothyroidism or concomitant diseases. There was a significant correlation (r = 0.363, P = .01) between seizure frequency and plasma thyroid hormone concentrations: the longer the interval between 2 seizure events, the higher the serum total thyroxine concentration. There was no correlation between the degree of alteration of thyroid hormone concentrations and the time span between the most recent seizure event and blood collection, the type of the most recent seizure event, the duration of the complete seizure history, or the predominant seizure type. These results suggest that IE can be a reason for euthyroid sick syndrome in dogs. The effect of phenobarbital on plasma thyroid hormone concentrations must be investigated in future studies, as it might be less pronounced than expected.

摘要

甲状腺功能正常的病态综合征在犬中很常见,可归因于非甲状腺疾病或使用多种药物(如苯巴比妥)进行治疗。在患有癫痫的犬中,尽管甲状腺功能正常,但使用抗惊厥药物治疗可导致血浆甲状腺激素浓度低于正常水平。对113只有癫痫发作活动的犬进行回顾性评估,以确定特发性癫痫(IE)对甲状腺激素浓度的影响。在60只患有IE的犬开始抗惊厥治疗之前采集血样。对照组包括34只患有IE并接受抗惊厥药物治疗的犬和19只患有继发性癫痫的犬。在38%未接受治疗且无甲状腺功能减退临床体征或并发疾病的IE犬中诊断出与甲状腺功能正常的病态综合征一致的甲状腺浓度。癫痫发作频率与血浆甲状腺激素浓度之间存在显著相关性(r = 0.363,P = .01):两次癫痫发作事件之间的间隔时间越长,血清总甲状腺素浓度越高。甲状腺激素浓度的改变程度与最近一次癫痫发作事件与采血之间的时间跨度、最近一次癫痫发作事件的类型、完整癫痫病史的持续时间或主要癫痫发作类型之间没有相关性。这些结果表明,IE可能是犬甲状腺功能正常的病态综合征的一个原因。未来的研究必须调查苯巴比妥对血浆甲状腺激素浓度的影响,因为其影响可能比预期的要小。

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