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目的 :探讨急性胰腺炎患者垂体 -甲状腺轴的功能变化及意义。方法 :用放射免疫分析 73例急性胰腺炎患者和 33例正常人血清T3 、FT3 、T4、FT4、rT3 、TSH水平 ,其中轻型急性胰腺炎 (mAP) 5 7例 ,重症急性胰腺炎 (sAP) 16例 ,并检测了其中 39例患者 (mAP2 8例 ,sAP11例 )恢复期血清上述激素水平。结果 :急性胰腺炎(mAP组和sAP组 )急性期T3 、FT3 、TSH显著低于正常 (p均 <0 0 5 ) ,rT3 升高 (p <0 0 1) ,恢复期T3 、FT3 虽有回升(与急性期比较p <0 0 1,0 0 5 ) ,但仍未恢复到正常水平 (与正常对照组比较p<0 0 1) ,rT3 恢复正常。mAP组急性期T4、FT4无异常改变 ,恢复期TSH接近正常 (p >0 0 5 ) ,sAP组急性期T4、FT4降低 ,与正常对照比较 (p <0 0 1) ,恢复期T4、FT4有所升高 (与急性期比较p<0 0 1) ,但均未达到正常水平 (p均 <0 0 1) ,同时发现mAP组T3 、FT3 、T4、FT4均高于sAP组 ,而rT3 、TSH两组无差异 (p >0 0 5 )。结论 :血清T3 、FT3 、T4、FT4水平可作为急性胰腺炎病情严重程度评估的一个指标。
Objective: To investigate the function and significance of pituitary-thyroid axis in patients with acute pancreatitis. Methods: The serum levels of T3, FT3, T4, FT4, rT3 and TSH in 73 patients with acute pancreatitis and 33 normal controls were analyzed by radioimmunoassay. Among them, 57 were mild acute pancreatitis (mAP), severe acute pancreatitis (SAP) 16 cases, and in which 39 cases of patients (mAP2 8 cases, sAP11 cases) convalescent serum levels of these hormones. Results: T3, FT3 and TSH in acute pancreatitis (mAP group and sAP group) were significantly lower than those in normal group (p <0.05), rT3 increased (p <0.01) (P <0 0 1, 0 0 5 compared with the acute phase), but still not returned to the normal level (p <0 01 compared with the normal control group), rT3 returned to normal. The levels of T4 and FT4 in the acute phase of mAP group were not changed abnormally in the acute phase, while the recovery period was close to normal (p> 0.05). The levels of T4 and FT4 in the acute phase of the sAP group were lower than those in the normal control group (p <0.01) (All p <0.01), but none of them reached the normal level (all p <0.01). The levels of T3, FT3, T4 and FT4 in mAP group were higher than those in sAP group, while rT3 , TSH two groups no difference (p> 0.05). Conclusion: Serum T3, FT3, T4, FT4 levels can be used as an indicator of the severity of acute pancreatitis.