Levothyroxine sodium in treatment of severe pulmonary tuberculosis with euthyroid sick syndrome

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Author:
LI Yue-cui(Department of Infectious Diseases,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)
TANG Shen-jie()
HU Wei-yue(Department of Infectious Diseases,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)
LI Jin(Department of Infectious Diseases,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)
LUO Hong-xia(Department of Infectious Diseases,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)
ZHOU Jin(Department of Infectious Diseases,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)
LI Cheng-hang(Department of Infectious Diseases,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)
Journal Title:
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
Issue:
Volume 03, Issue 05, 2010
DOI:
10.3760/cma.j.issn.1674-2397.2010.05.004
Key Word:
Pulmonary tuberculosis;Euthyroid sick syndrome;Low triiodothyronine syndrome;Thyroxine

Abstract: Objective To evaluate the efficacy of low-dose levothyroxine sodium in treatment of severe pulmonary tuberculosis with euthyroid sick syndrome(ESS). Methods One hundred and twenty inpatients with severe pulmonary tuberculosis and ESS were randomly divided into treatment group and control group by gender, age, disease duration and severity. Both groups were given anti- tuberculosis, antiinfection treatment and nutritional support for 2 weeks; patients in treatment group were given low-dose levothyroxine sodium additionally. Thyroid function, clinical improvements, increase of albumin, reduction of acid-fast bacilli, improvements on images and the mortality rates were compared between the groups.Results After 2 weeks of treatment, symptoms including fever, cough and night sweats were improved in both groups. Marked improvements were observed in 19 patients(31.7%)of treatment group and 8 patients (13.3%)of control group(χ2 = 5. 73, P < 0.05). Clearance rate of acid-fast bacilli in treatment group was 25.0%(15/60), but that in the control was only 6.7%(4/60)(χ2 = 7. 50, P < 0.01). Serum albumin in the treatment group was increased to(34.2 ±0.4)g/L after the treatment, and that in the control group was(29.1 ±0.6)g/L(t =2.42, P<0.05). T3 and FT3 were significantly increased in both groups, but more significant difference was observed in the treatment group(t = 59. 42 and 50. 66, P < 0. 01). No empty closed after treatment in both groups, but the effective rate in treatment group was significantly higher than that in the control group(93.3% vs. 76.7%, χ2 =6. 54, P<0.05). Two patients in control group died(2/60, 3. 3%), while no death was reported in treatment group. Conclusions Low-dose levothyroxine sodium treatment is effective for ESS in patients with severe pulmonary tuberculosis.Improvement on low T3 syndrome may be an important indicator for the overall improvement or recovery.

  • [1]李爱美,许忆新.重症肺结核合并肺部感染70例临床分析.临床肺科杂志,2006,11(6):798.
  • [2]谢丹红.正常甲状腺病态综合征研究进展.新医学,2005,36(4):40.
  • [3]张卫斌,李学义.重症肺结核与多脏器衰竭.中华结核和呼吸杂志,1991,14(I):38-39.
  • [4]王煜,刘雅,王佑娟,等.重症慢性肺心病患者与非甲状腺疾病甲状腺功能异常综合症.华西医学,2004,19(4):560-561.
  • [5]赵岚.糖尿病并发肺结核患者甲状腺激素测定及临床意义.陕西医学杂志,2007,36(9):1222-1224.
  • [6]Beigneux AP,Moser AH,Shigenaga JK,et al.Sick euthyroid syndrome is associated with decreased TR expression and DNA binding in mouse liver.Am J Physiol Endocrinol Metab,2003,284(1):E228-E236.
  • [7]龙达,李燕,刘启明.慢性充血性心力衰竭患者血清甲状腺素水平变化及其意义.医学临床研究,2007,24(2):18-20.
  • [8]何同林.低三碘甲状腺原氨酸低甲状腺素综合征21例诊治体会.新医学,2001,32(5):287-289.
  • [9]Cerillo AG,Sabatino L,Bevilacqua S,et al.Nonthyroidal illness syndrome in off-pump coronary artery bypass grafting.Ann Thorac Surg,2003,75(1):82-87.
  • [10]Stathatos N,Wartofsky L.The euthyroid sick syndrome:is there a physiologic rationale for thyroid hormone treatment?.J Endocrinol Invest,2003,26(12):1174-1179.
  • [11]王海鱼,陈金华,夏斌赞.小剂量甲状腺素治疗慢性充血性心力衰竭伴低T3、T4综合征的临床研究.实用医学杂志,2005,21(3):271-272.
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