Fonction thyroïdienne du brûlé : Incidence de la thérapeutique iodée
L'étude de la fonction thyroïdienne de trois groupes d'adultes : 13 brûlés traités par antiseptique non iodé (groupe I), 15 brûlés traités par antiseptique iodé (groupe II) et 50 témoins, a eu pour but de préciser l'incidence de la surcharge iodée plasmatique sur l'équilibre horm...
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Published in | La revue de medecine interne Vol. 8; no. 1; pp. 21 - 26 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | French |
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Paris
Elsevier SAS
1987
Elsevier |
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Abstract | L'étude de la fonction thyroïdienne de trois groupes d'adultes : 13 brûlés traités par antiseptique non iodé (groupe I), 15 brûlés traités par antiseptique iodé (groupe II) et 50 témoins, a eu pour but de préciser l'incidence de la surcharge iodée plasmatique sur l'équilibre hormonal particulier du brûlé. La surface cutanée brûlée et les paramètres hormonaux thyroïdiens ont été déterminés avant, puis de façon hebdomadaire pendant les trois premières semaines d'évolution suivant l'accident. Avant traitement, le profil hormonal du brûlé est caractérisé par une baisse de la T
4 et de la T
3 totales, une élévation de la réverse T
3 (rT
3) et une baisse de la thyroxin binding globulin (TBG). L'index de thyroxine libre T
4/TBG est normal alors que le T
3 test (T
3RU) est élevé. Au cours du traitement, l'iodémie s'élève significativement (p < 0,02) de 6,4 ± 0,4 μg/100 ml à 20,7 ± 4,7 μg/100 ml, dans le groupe II. Les paramètres thyroïdiens non différents entre les groupes I et II, se normalisent progressivement à l'exception du T
3RU qui reste élevé à la troisième semaine d'évolution. La rT
3 et le T
3RU sont corrélés (p < 0,001) à la surface cutanée brûlée. Les particularités réversibles de l'équilibre thyroïdien du brûlé sont d'autant plus nettes que la surface cutanée brûlée est importante. La fonction thyroïdienne du brûlé adulte n'apparait pas modifiée par la surcharge iodée plasmatique induite par l'emploi d'antiseptiques cutanés iodés.
Thyroid function was studied in 3 groups of adults (groupe I = 13 burned patients treated with non iodinated antiseptic, group II = 15 burned patients treated with polyvidone iodine, group III = 50 control subjects) in order to examine : i) the thyroid hormone status in burned patients, ii) the possible incidence of plasma iodine overload on these endocrine parameters. Burned skin area and thyroid function were measured before treatment, then weekly for 3 weeks. Before treatment a decrease in plasma T
4 and T
3 with an increase in reverse T
3 (rT
3) and a decrease in plasma thyroxin binding globulin (TBG) were observed in burned patients. Free T
4 index (T
4/TBG) was normal, but T
3 resine uptake (T
3RU) was elevated. During treatment, plasma iodine increase sharply from 6.4 ± 0.4 to 20.7 ± 4.7 μg/100 ml (p < 0.02) in group II. Endocrine parameters (not different between group I and II) progressively returned to normal, except for T
3RU which remained elevated until the third week. rT
3, T
4 and T
3RU correlated (P < 0.001) with burned skin area. To conclude, the reversible particularities of thyroid function in burned patients are positively correlated with burned area. The thyroid function does not seen to be modified by plasma iodine overload. |
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AbstractList | L'étude de la fonction thyroïdienne de trois groupes d'adultes : 13 brûlés traités par antiseptique non iodé (groupe I), 15 brûlés traités par antiseptique iodé (groupe II) et 50 témoins, a eu pour but de préciser l'incidence de la surcharge iodée plasmatique sur l'équilibre hormonal particulier du brûlé. La surface cutanée brûlée et les paramètres hormonaux thyroïdiens ont été déterminés avant, puis de façon hebdomadaire pendant les trois premières semaines d'évolution suivant l'accident. Avant traitement, le profil hormonal du brûlé est caractérisé par une baisse de la T
4 et de la T
3 totales, une élévation de la réverse T
3 (rT
3) et une baisse de la thyroxin binding globulin (TBG). L'index de thyroxine libre T
4/TBG est normal alors que le T
3 test (T
3RU) est élevé. Au cours du traitement, l'iodémie s'élève significativement (p < 0,02) de 6,4 ± 0,4 μg/100 ml à 20,7 ± 4,7 μg/100 ml, dans le groupe II. Les paramètres thyroïdiens non différents entre les groupes I et II, se normalisent progressivement à l'exception du T
3RU qui reste élevé à la troisième semaine d'évolution. La rT
3 et le T
3RU sont corrélés (p < 0,001) à la surface cutanée brûlée. Les particularités réversibles de l'équilibre thyroïdien du brûlé sont d'autant plus nettes que la surface cutanée brûlée est importante. La fonction thyroïdienne du brûlé adulte n'apparait pas modifiée par la surcharge iodée plasmatique induite par l'emploi d'antiseptiques cutanés iodés.
Thyroid function was studied in 3 groups of adults (groupe I = 13 burned patients treated with non iodinated antiseptic, group II = 15 burned patients treated with polyvidone iodine, group III = 50 control subjects) in order to examine : i) the thyroid hormone status in burned patients, ii) the possible incidence of plasma iodine overload on these endocrine parameters. Burned skin area and thyroid function were measured before treatment, then weekly for 3 weeks. Before treatment a decrease in plasma T
4 and T
3 with an increase in reverse T
3 (rT
3) and a decrease in plasma thyroxin binding globulin (TBG) were observed in burned patients. Free T
4 index (T
4/TBG) was normal, but T
3 resine uptake (T
3RU) was elevated. During treatment, plasma iodine increase sharply from 6.4 ± 0.4 to 20.7 ± 4.7 μg/100 ml (p < 0.02) in group II. Endocrine parameters (not different between group I and II) progressively returned to normal, except for T
3RU which remained elevated until the third week. rT
3, T
4 and T
3RU correlated (P < 0.001) with burned skin area. To conclude, the reversible particularities of thyroid function in burned patients are positively correlated with burned area. The thyroid function does not seen to be modified by plasma iodine overload. |
Author | Ménard, J.F. Rieu, M. Luton, J.P. Kuhn, J.M. Vallée, G. Wasserman, D. Bricaire, H. Izembart, M. |
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Cites_doi | 10.1016/S0140-6736(81)91196-X 10.1210/jcem-41-1-191 10.1530/acta.0.1010542 10.1172/JCI110478 10.1002/cpt1975173355 10.3109/02844317909013013 10.1210/jcem-54-6-1229 10.1097/00005373-198009000-00001 10.1016/0002-9378(70)90087-6 10.1177/030006057800600510 10.1210/jcem-54-4-757 10.1210/jcem-51-1-135 10.1210/jcem-49-1-63 10.1056/NEJM198502283120904 10.1210/jcem-44-2-398 10.1210/jcem-44-2-237 10.1056/NEJM197707212970318 10.1001/archsurg.1980.01380040067012 10.1016/S0140-6736(76)92774-4 |
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Copyright | 1987 les Éditions J.-B. Baillière 1988 INIST-CNRS |
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Keywords | brûlure antiseptique iodé hormone thyroïdienne Brûlure Hormone thyroïdienne Peau pathologie Traitement Iode composé Voie externe Exploration hormonale Homme Antiseptique Chimiothérapie |
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Lancet doi: 10.1016/S0140-6736(76)92774-4 contributor: fullname: Burger |
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Snippet | L'étude de la fonction thyroïdienne de trois groupes d'adultes : 13 brûlés traités par antiseptique non iodé (groupe I), 15 brûlés traités par antiseptique... |
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SubjectTerms | antiseptique iodé brûlure hormone thyroïdienne Peau, ongle, cheveu, phanère Pharmacologie. Traitements medicamenteux Sciences biologiques et medicales Sciences medicales |
Title | Fonction thyroïdienne du brûlé : Incidence de la thérapeutique iodée |
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