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非甲状腺疾病综合征期间和急性病犬康复过程中的甲状腺功能测试。

Thyroid function tests during nonthyroidal illness syndrome and recovery in acutely ill dogs.

机构信息

Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech University, Blacksburg, Virginia, USA.

出版信息

J Vet Intern Med. 2024 Jan-Feb;38(1):111-122. doi: 10.1111/jvim.16947. Epub 2023 Nov 30.

Abstract

BACKGROUND

Nonthyroidal illness syndrome (NTIS) can result in thyroid function test alterations that mimic hypothyroidism. The duration of NTIS-induced changes in dogs is not well-described.

OBJECTIVES

Document alterations in thyroid function tests during NTIS and recovery, and the time necessary for their resolution.

ANIMALS

From 103 dogs sampled, 25 euthyroid dogs with acute, resolvable illness having a low serum total thyroxine (TT4) concentration on admission were analyzed.

METHODS

Prospective observational study. Serum TT4 concentration was measured in 103 dogs within 4 hours of admission. If below the reference interval (RI), subsequent serum samples were obtained every 24 hours from admission until discharge (acute phase) and at 2 weeks and 4 weeks after discharge (recovery phase). Serum samples were submitted for batch measurement of serum TT4, free thyroxine (fT4), total 3,5,3'-triiodothyronine (TT3), and thyroid-stimulating hormone (TSH) concentrations.

RESULTS

In the cohort of dogs analyzed, serum TT4, TT3, and fT4 concentrations were below the RI in 100%, 80%, and 16% at admission; 20%, 80%, and 0% at discharge; 4%, 8%, and 0% at 2 weeks; and 0%, 0%, and 0% at 4 weeks, respectively. Serum TSH concentration was within the RI in 100% at admission and discharge, and above the RI in 4% and 12% at 2 weeks and 4 weeks, respectively.

CONCLUSIONS AND CLINICAL IMPORTANCE

Naturally occurring NTIS in dogs induces alterations in thyroid function tests during acute illness and recovery. Measurement of serum TT4 concentration 2 to 4 weeks after discharge or serum fT4 concentration by ED during illness is recommended for accurate assessment of thyroid function in acutely ill dogs.

摘要

背景

非甲状腺疾病综合征(NTIS)可导致甲状腺功能测试改变,类似于甲状腺功能减退。犬 NTIS 引起的变化持续时间尚未得到很好的描述。

目的

记录 NTIS 期间和恢复过程中甲状腺功能测试的变化,并记录其恢复所需的时间。

动物

从 103 只接受采样的犬中,分析了 25 只患有急性、可治愈疾病且入院时血清总甲状腺素(TT4)浓度较低的甲状腺功能正常犬。

方法

前瞻性观察研究。在入院后 4 小时内对 103 只犬进行血清 TT4 浓度检测。如果低于参考区间(RI),则在入院后每隔 24 小时采集后续血清样本,直至出院(急性期),以及出院后 2 周和 4 周(恢复期)。血清样本用于批量检测血清 TT4、游离甲状腺素(fT4)、总三碘甲状腺原氨酸(TT3)和促甲状腺激素(TSH)浓度。

结果

在所分析的犬队列中,入院时血清 TT4、TT3 和 fT4 浓度分别低于 RI 的 100%、80%和 16%;出院时分别为 20%、80%和 0%;出院后 2 周时分别为 4%、8%和 0%;出院后 4 周时分别为 0%、0%和 0%。入院和出院时血清 TSH 浓度均在 RI 范围内,而在出院后 2 周和 4 周时分别为 4%和 12%时高于 RI。

结论和临床意义

犬自然发生的 NTIS 在急性疾病和恢复期会引起甲状腺功能测试的改变。建议在急性疾病犬出院后 2 至 4 周测量血清 TT4 浓度或通过 ED 测量血清 fT4 浓度,以准确评估甲状腺功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2e/10800236/7d1a9bd2c62e/JVIM-38-111-g006.jpg

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