Papanas N, Papatheodorou K, Papazoglou D, Gioka T, Antonoglou C, Kotsiou S, Maltezos E
Second Department of Internal Medicine, Democritus University of Thrace, Ethnikis Antistasis 44, Alexandroupolis 68100, Greece.
Cytokine. 2008 Feb;41(2):121-6. doi: 10.1016/j.cyto.2007.10.014. Epub 2007 Dec 31.
To investigate the potential association between serum inflammatory cytokine levels and post-thyroidectomy thyroxine replacement dose in patients with or without compensated heart failure.
The study included 42 patients (group A: 20 men, mean age of 54.5+/-6.8 years) with NYHA I or II heart failure and 54 patients (group B: 25 men, mean age of 52.9+/-7.1 years) without heart failure. All patients had undergone total thyroidectomy and were euthyroid on a stable thyroxine replacement dose. Serum Interleukin-1b (IL-1b), Tumor Necrosis Factor alpha (TNF-alpha), Interleukin-6 (IL-6), TSH, T3, T4, fT3 and fT4 were measured.
Both groups exhibited a significant positive correlation between IL-6 and levothyroxine replacement dosage (group A: r=0.708, p<0.001; group B: r=0.345, p=0.012) and a negative correlation between IL-6 and T3 (group A: r=-0.342, p=0.023, group B: r=-0.294, p=0.035). Significant independent predictors of levothyroxine replacement dosage were IL-6 (p<0.001) and TNF-alpha (p=0.007) in group A (58.3% of dosage variation) and only IL-6 (p=0.012) in group B (10.1% of dosage variation).
In both groups, a significant positive correlation was observed between IL-6 and levothyroxine replacement dosage, but this correlation was stronger in group A. In the same group, there was evidence for a more pronounced influence of cytokines on levothyroxine dosage.
探讨有无代偿性心力衰竭患者血清炎症细胞因子水平与甲状腺切除术后甲状腺素替代剂量之间的潜在关联。
本研究纳入42例纽约心脏协会（NYHA）心功能I级或II级心力衰竭患者（A组：20例男性，平均年龄54.5±6.8岁）和54例无心力衰竭患者（B组：25例男性，平均年龄52.9±7.1岁）。所有患者均接受了甲状腺全切术，且甲状腺素替代剂量稳定，甲状腺功能正常。检测血清白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离三碘甲状腺原氨酸（fT3）和游离甲状腺素（fT4）。
两组患者IL-6与左甲状腺素替代剂量均呈显著正相关（A组：r = 0.708，p < 0.001；B组：r = 0.345，p = 0.012），IL-6与T3呈负相关（A组：r = -0.342，p = 0.023；B组：r = -0.294，p = 0.035）。A组中，左甲状腺素替代剂量的显著独立预测因素为IL-6（p < 0.001）和TNF-α（p = 0.007）（占剂量变化的58.3%），B组中仅为IL-6（p = 0.012）（占剂量变化的10.1%）。
两组患者中，IL-6与左甲状腺素替代剂量均呈显著正相关，但A组这种相关性更强。在同一组中，有证据表明细胞因子对左甲状腺素剂量的影响更为显著。
