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胆源性和高脂血症性急性胰腺炎患者血清甲状腺激素和促甲状腺激素水平:预测疾病严重程度的差异及价值

Serum levels of thyroid hormones and thyroid stimulating hormone in patients with biliogenic and hyperlipidaemic acute pancreatitis: Difference and value in predicting disease severity.

作者信息

Yang Ning, Zhang Dong-Lei, Hao Jian-Yu, Wang Guang

机构信息

Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

J Int Med Res. 2016 Apr;44(2):267-77. doi: 10.1177/0300060515618052. Epub 2016 Jan 25.

Abstract

OBJECTIVES

To compare retrospectively serum levels of thyroid hormones (THs) and thyroid stimulating hormone (TSH) between patients with biliogenic acute pancreatitis (BAP) and those with hyperlipidaemic acute pancreatitis (HLAP), in order to assess their value for predicting the severity of acute pancreatitis (AP).

METHODS

Patients with AP were divided into BAP and HLAP groups, then further divided into either a mild AP (MAP) group or a moderately severe AP (MSAP) group. Routine blood parameters were measured. Free tri-iodothyronine (FT3), free thyroxine (FT4) and TSH levels were measured.

RESULTS

Seventy-six patients with AP were enrolled in the study. FT3 and TSH levels were significantly higher in patients with MAP than in patients with MSAP. FT4 and TSH levels were significantly lower in the HLAP group than in the BAP group. TSH levels in both MAP and MSAP patients were significantly lower in the HLAP group than in the BAP group. TSH was inversely correlated with triglyceride levels in patients with HLAP. FT3 was a risk factor for MSAP in patients with AP and also demonstrated moderate accuracy in predicting AP severity.

CONCLUSIONS

THs and TSH decrease with the severity of AP, especially in patients with HLAP. FT3 may be a useful biomarker for the early assessment of the severity of AP.

摘要

目的

回顾性比较胆源性急性胰腺炎(BAP)患者与高脂血症性急性胰腺炎(HLAP)患者的血清甲状腺激素(THs)水平和促甲状腺激素(TSH)水平,以评估其对预测急性胰腺炎(AP)严重程度的价值。

方法

将AP患者分为BAP组和HLAP组,再进一步分为轻症急性胰腺炎(MAP)组或中度重症急性胰腺炎(MSAP)组。检测常规血液参数。测定游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和TSH水平。

结果

76例AP患者纳入研究。MAP患者的FT3和TSH水平显著高于MSAP患者。HLAP组的FT4和TSH水平显著低于BAP组。HLAP组中MAP和MSAP患者的TSH水平均显著低于BAP组。HLAP患者的TSH与甘油三酯水平呈负相关。FT3是AP患者发生MSAP的危险因素,在预测AP严重程度方面也具有中等准确性。

结论

THs和TSH随AP严重程度降低,尤其是HLAP患者。FT3可能是早期评估AP严重程度的有用生物标志物。

相似文献

本文引用的文献

1
Thyroid hormone regulation of hepatic lipid and carbohydrate metabolism.甲状腺激素对肝脏脂质和碳水化合物代谢的调节。
Trends Endocrinol Metab. 2014 Oct;25(10):538-45. doi: 10.1016/j.tem.2014.07.001. Epub 2014 Aug 12.
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Nonthyroidal illness syndrome.非甲状腺疾病综合征。
Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):478-84. doi: 10.1097/01.med.0000433069.09294.e8.
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Eur J Clin Invest. 2011 Feb;41(2):212-20. doi: 10.1111/j.1365-2362.2010.02395.x. Epub 2010 Oct 21.
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Nat Rev Gastroenterol Hepatol. 2010 Sep;7(9):495-502. doi: 10.1038/nrgastro.2010.114. Epub 2010 Aug 10.

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