非甲状腺疾病综合征脱碘酶变化机制及其对疾病预后的影响  

Change mechanism of deiodinase in nonthyroid illness syndrome and its effect on disease prognosis

作　　者：陈磊 王恺隽 邓雪 康金锁 CHEN Lei;WANG Kaijun;DENG Xue;KANG Jinsuo(Department of Clinical Laboratory,Fuwai Yunnan Cardiovascular Hospital,Kunming,Yunnan,650000,China;Department of Clinical laboratory,Fuwai Hospital CAMS&PUMC,Beijing,100037,China;Department of Clinical Laboratory,Kunming Psychiatric Hospital,Kunming,Yunnan,650000,China)

机构地区：[1]云南省阜外心血管病医院检验科,云南昆明650000 [2]中国医学科学院阜外医院实验诊断中心,北京100037 [3]昆明市精神病院检验科,云南昆明650000

出　　处：《当代医学》2022年第14期183-187,共5页Contemporary Medicine

摘　　要：非甲状腺疾病综合征(NTIS)常伴血清三碘甲腺原氨酸(T_(3))、四碘甲腺原氨酸(T_(4))降低,反T_(3)升高,以往普遍认为下丘脑-垂体-甲状腺轴功能变化是导致NTIS的主要原因,且合并NTIS时不同器官局部脱碘酶变化基本相同,疾病并发NTIS时对预后影响不明显。但总结相关动物实验和临床研究发现,白细胞介素-6、白细胞介素-1、肿瘤坏死因子-α等及皮质醇、谷胱甘肽等物质介导的Ⅰ型、Ⅱ型脱碘酶活性降低、Ⅲ型脱碘酶活性升高是导致NTIS的重要原因;当非酒精性脂肪性肝病、脓毒症、心肌梗死等疾病患者伴有NTIS时,预后较差。为改善NITS预后,可利用T_(3)类似物、N-乙酰半胱氨酸纠正NTIS。因此,本文对非甲状腺疾病综合征脱碘酶变化机制及其对疾病预后的影响进行综述。Nonthyroid illness syndrome(NTIS)was characterized by the decreased of serum triiodothyronine(T_(3))and tetraiodothyronine(T_(4))and the increased of serum anti T_(3),In the past,it had been widely believed that the change of hypothalamic-pituitary-thyroid axis function alternation may be the major reason of NTIS,the changes of local deiodinase in different organs were basically the same when combined with NTIS,and the prognosis was not significantly affected when the disease was complicated with NTIS.But,summary of relevant animal experiments and clinical studies and found that the decrease of typeⅠand typeⅡdeiodinase activity and the increase of typeⅢdeiodinase activity mediated by interleukin 6,interleukin-6,tumor necrosis factor-α,cortisol and glutathione are important cause of NTIS;when patients with nonalcoholic fatty liver disease,sepsis,and myocardial infarction and other diseases are accompanied by NTIS,the prognosis is poor.In order to improve the prognosis of NITS,T_(3) analogues and N-acetylcysteine can be used to correct NTIS.Therefore,this paper reviews the change mechanism of deiodinase in non thyroid illness syndrome and its influence on the prognosis of the disease.

关 键 词：非甲状腺疾病综合征 脱碘酶 危险因素 预后 

分 类 号：R58[医药卫生—内分泌]