Uysal Erdal, Kirdak Turkay, Korun Nusret
a Department of Surgery , Uludag University School of Medicine , Bursa, Turkey.
J Invest Surg. 2015;28(6):317-22. doi: 10.3109/08941939.2015.1020400. Epub 2015 Aug 13.
Although the effects of increased intraabdominal pressure on the abdominal organs are well known, there is a limited data regarding its effects on the thyroid hormones. The aim of this study is to investigate the changes in thyroid hormone profiles during stress endocrine response induced by increased intraabdominal pressure, which was obtained by pneumoperitoneum in rats.
A hundred-fifty female wistar albino rats were divided into three main groups, according to intraabdominal pressure applied; Control (Group 1), (n:30), low pressure, 15 mmHg, (Groups 2 and 3), (n:60), and high intraabdominal pressure, 25 mmHg, (Groups 4 and 5), (n:60) groups. Groups 2, 3, 4, 5 were divided into three subgroups separately, according to duration of intraabdominal pressure. Rats in Groups 3 and 5 were decompressed at the end of times indicated (15th, 30th, and 45th min) and blood samples were obtained. Whereas blood samples from Groups 2 and 4 were drawn without decompression at the end of times indicated. Measurements included thyroid stimulating hormone, cortisole, vasopressin, adrenocorticotropic hormone, triiodotronin and thyroxin.
Our study revealed that blood TSH levels reduce and free T3 and T4 levels increase in case of prolonged intraabdominal pressure increase that cause abdominal compartment syndrome. The change in blood thyroid hormone levels are encountered prominently on 30th and 45th min.
Secretion of vasopressin, adrenocorticotropic Hormone and cortisol increases with increasing intraabdominal pressure. At high pressures, thyroid stimulating hormone secretion decreases while the secretion of triiodotronin increases. The effect of this case on the clinical findings has not been fully clarified yet and it needs further studies to clarify underlying mechanism. In this perspective, the findings of this study may be used in further clinical and experimental studies.
尽管腹腔内压力升高对腹部器官的影响已为人熟知,但关于其对甲状腺激素影响的数据有限。本研究旨在探讨大鼠气腹所致腹腔内压力升高引起应激内分泌反应期间甲状腺激素谱的变化。
150只雌性Wistar白化大鼠根据施加的腹腔内压力分为三个主要组:对照组(第1组),(n = 30),低压组,15 mmHg,(第2组和第3组),(n = 60),以及高腹腔内压力组,25 mmHg,(第4组和第5组),(n = 60)。第2、3、4、5组根据腹腔内压力持续时间分别再分为三个亚组。第3组和第5组在指定时间(第15、30和45分钟)结束时减压并采集血样。而第2组和第4组在指定时间结束时不减压采血。测量指标包括促甲状腺激素、皮质醇、血管加压素、促肾上腺皮质激素、三碘甲状腺原氨酸和甲状腺素。
我们的研究表明,在导致腹腔间隔室综合征的腹腔内压力持续升高的情况下,血TSH水平降低,游离T3和T4水平升高。血甲状腺激素水平的变化在第30和45分钟时最为明显。
血管加压素、促肾上腺皮质激素和皮质醇的分泌随腹腔内压力升高而增加。在高压下,促甲状腺激素分泌减少,而三碘甲状腺原氨酸分泌增加。这种情况对临床发现的影响尚未完全阐明,需要进一步研究以明确潜在机制。从这个角度来看,本研究结果可用于进一步的临床和实验研究。