Mainwaring R D, Lamberti J J, Billman G F, Nelson J C
Division of Cardiac Surgery, Children's Hospital and Health Center, San Diego, California.
Ann Thorac Surg. 1994 Oct;58(4):1078-82. doi: 10.1016/0003-4975(94)90459-6.
Thyroid hormone has numerous effects on cardiovascular function in the adult. The present study was undertaken to evaluate the effects of cardiopulmonary bypass and deep hypothermia on thyroid function in the neonate. Ten newborns were studied preoperatively and postoperatively. The total and free triiodothyronine, total and free thyroxine, thyroid-stimulating hormone, and thyroglobulin levels were measured by immunoassays. The data demonstrated a transient rise in the free thyroxine level associated with and followed by significant reductions in the free and total triiodothyronine, total thyroxine, thyroid-stimulating hormone, and thyroglobulin levels in the early postoperative period. By the fifth postoperative day, the free and total triiodothyronine and total thyroxine levels were returning toward the preoperative levels under the influence of an elevated thyroid-stimulating hormone level. These results suggest that the combination of cardiopulmonary bypass and deep hypothermia can result in a transient suppression of the pituitary-thyroid axis in the neonate.
甲状腺激素对成年人的心血管功能有众多影响。本研究旨在评估体外循环和深度低温对新生儿甲状腺功能的影响。对10名新生儿进行了术前和术后研究。通过免疫测定法测量总三碘甲状腺原氨酸、游离三碘甲状腺原氨酸、总甲状腺素、游离甲状腺素、促甲状腺激素和甲状腺球蛋白水平。数据显示，术后早期游离甲状腺素水平短暂升高，随后游离和总三碘甲状腺原氨酸、总甲状腺素、促甲状腺激素和甲状腺球蛋白水平显著降低。到术后第5天，在促甲状腺激素水平升高的影响下，游离和总三碘甲状腺原氨酸以及总甲状腺素水平恢复到术前水平。这些结果表明，体外循环和深度低温相结合可导致新生儿垂体 - 甲状腺轴的短暂抑制。
