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Changes in thyroid function in patients with liver failure and their clinical significance:A clinical study of non-thyroidal illness syndrome in patients with liver failure

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Hepatobiliary & Pancreatic Diseases International 2020年第6期19卷 561-566页

作者： Hong-Ling Feng Qian Li Wu-Kui Cao Ji-Ming Yang Intensive Care Unit Tianjin Second People’s HospitalTianjin 300192China

Background:non-thyroidal illness syndrome(NTIS)develops in a large proportion of critically ill patients and is associated with high risk for *** aimed to investigate the correlation between NTIS and liver failure,and the short-term mortality of patients with these ***:The clinical data of 87 patients with liver failure were collected retrospectively,73 of them were randomly selected for an observational study and to establish prognostic models,and 14 for model *** 73 sex-and age-matched patients with mild chronic hepatitis were randomly selected as a control *** free triiodothyronine(FT3),free thyroxine(FT4),and thyroid-stimulating hormone(TSH)were *** clinical characteristics of patients with liver failure and NTIS were *** follow-up of patients lasted for 3 ***,the values for predicting short-term mortality of model for end-stage liver disease(MELD),Child-Turcotte-Pugh(CTP),chronic liver failure-sequential organ failure assessment(CLIF-SOFA)scores,FT3-MELD model,and FT3 were ***:The observation group had significantly lower FT3(2.79±0.71 vs.4.43±0.75 pmol/L,P<0.001)and TSH[0.618(0.186-1.185)vs.1.800(1.570-2.590)mIU/L,P<0.001],and higher FT4(19.51±6.26 vs.14.47±2.19 pmol/L,P<0.001)than the control *** was diagnosed in 49 of the patients with liver failure(67.12%).In the observation group,patients with NTIS had a higher mortality rate than those without(63.27%vs.25.00%,P=0.002).Across the whole cohort,the 3-month mortality was 50.68%.The international normalized ratios(INR)were 2.40±1.41 in survivors and 3.53±1.81 in deaths(P=0.004),the creatinine(Cr)concentrations were 73.27±36.94μmol/L and 117.08±87.98μmol/L(P=0.008),the FT3 concentrations were 3.13±0.59 pmol/L and 2.47±0.68 pmol/L(P<0.001),the MELD scores were 22.19±6.64 and 29.57±7.99(P<0.001),the CTP scores were 10.67±1.53 and 11.78±1.25(P=0.001),and the CLIF-SOFA scores were 8.42±1.68 and 10.16±2.03(P<0.001),resp

关键词： Liver failure non-thyroidal illness syndrome Free triiodothyronine Prognosis

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Cardiovascular mechanisms of thyroid hormones and heart failure:Current knowledge and perspectives

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World Journal of Cardiology 2024年第5期16卷 226-230页

作者： Viktor Culic Department of Cardiology and Angiology University Hospital Centre SplitUniversity of Split School of MedicineSplit 21000Croatia

A multiple hormonal imbalance that accompanies heart failure(HF)may have a significant impact on the clinical course in such *** non-thyroidal illness syndrome(NTIS),also referred to as euthyroid sick syndrome or low triiodothyronine syndrome,can be found in about 30%of patients with *** represents a systemic adaptation to chronic illness that is associated with increased cardiac and overall mortality in patients with *** conclusions on thyroid-stimulating hormone,free triiodothyronine,total and free thyroxine are currently unresolved,serum total triiodothyronine levels and the ratio of free triiodothyronine to free thyroxine seem to provide the best correlates to the echocardiographic,laboratory and clinical parameters of disease *** patients with either hyper-or hypothyroidism should be treated according to the appropriate guidelines,but the therapeutic approach to NTIS,with or without HF,is still a matter of *** treatment options include better individual titration of levothyroxine therapy,combined triiodothyronine plus thyroxine therapy and natural measures to increase *** research should further examine the cellular and tissue mechanisms of NTIS as well as new therapeutic avenues in patients with HF.

关键词： Heart failure non-thyroidal illness syndrome Low triiodothyronine syndrome Therapy Thyroxine Triiodothyronine

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