常温和低温体外循环对甲状腺功能影响的试验研究  

The Experimental Study of Thyroid Function during Hypothermic and Normothermic Cardiopulmonary Bypass in Dogs

作　　者：卢光临[1] 单靖华[1] 李述杰 

机构地区：[1]潍坊医学院附属医院,山东潍坊261031 [2]潍坊耳鼻喉医院

出　　处：《潍坊医学院学报》2006年第4期244-246,共3页Acta Academiae Medicinae Weifang

摘　　要：目的观察犬低温和常温体外循环(CPB)中FT3,FT4,TSH的变化。方法11只健康杂种犬随机分为低温组(H组,n=5,咽低温28℃)和常温组(N组,n=6,咽低温>35.3℃),分别于体外循环前、体外循环30min、体外循环90min、体外循环停机后60min抽取静脉血,用放射免疫法测定FT3,FT4,TSH浓度。结果FT3:H组维持在CPB前水平,N组则呈明显下降趋势:CPB 30min,CPB 90min低于CPB前(P<0.05),且在CPB后60min,N组明显低于H组(P<0.01)相应时点数值。FT4:两组皆略上升,组内、组间比较差异无显著性。TSH:两组呈上升趋势,仅CPB 90min时N组高于CPB前(P<0.05)。结论家犬温氧合血持续灌注、常温体外循环比冷晶体液间断灌注、低温体外循环导致更明显的低FT3综合征,而FT4,TSH无明显变化。Objective To investigate the changes of plasma free thyroid honnones （FT4 and FT5 ） ,thyroid-stimulating hormone （TSH） concentrations during h.vpothennie cardiopuhnonary bypass（CPB） and nonnothermic CPB. Methods Eleven dogs were randomly divided into two groups：hypothermie group （group H, n = 5） and normothermie group （group N, n = 6）. Group H was infused hv intermittent 4℃ cry stalloid cardioplegia solution, group N received continuous warm oxygenated cardioplegia blood during the CPB. The lowest pharyngonasal temperature of two groups was 28 ℃ and 35.3 ℃ respectively. Aortic clamping lasted 60 minutes and the CPB lasted 90 minutes. Blood samples were taken before CPB, 30min, 90min during CPB, and 60min after bypass. Results As compared with basic values, values of FT3 were significantly depressed up at CPB 30min, CPB 90min in grnup N（ P 〈 0.05）.After CPB 60 min,values of FT3 was dramatically lower in group N than that in group H（ P 〈 0.01 ） ;While in group H, values of FT3 failed to show difference. FT4 levels relnained within normal ranges at all sampling times. At CPB 90min, the contents of TSH in group N was higher than that before CPB. Conclusion It is increasingly evident that normothermie eardiopuhnonary bypass affects thyroid hormone metabolism in dogs,leading to a transient depression characterized by low levels of circulating FT3.

关 键 词：游离甲状腺素 促甲状腺素 体外循环 

分 类 号：R615[医药卫生—外科学] R653[医药卫生—临床医学]