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甲状腺激素对心脏和肾脏功能的影响。

Effects of thyroid hormones on heart and kidney functions.

作者信息

Capasso G, De Tommaso G, Pica A, Anastasio P, Capasso J, Kinne R, De Santo N G

机构信息

Chair of Nephrology, Second University of Naples, Napoli, Italy.

出版信息

Miner Electrolyte Metab. 1999 Jan-Apr;25(1-2):56-64. doi: 10.1159/000057421.

Abstract

Thyroid hormones affect the functions of several organs including the heart and kidney. Using isolated left papillary muscles we have investigated the action of thyroid hormones on the mechanical and electrical properties of the heart. We found that pure hypothyroidism causes a depression in contractile and electrical parameters, but we noticed that superimposed hypoparathyroidism accounts for the marked prolongation in contractile kinetics and action potential duration. At kidney level we have shown that thyroid hormones affect proximal tubular sodium transport and this effect is only partially mediated by the action of thyroid hormones on Na-K-ATPase activity. Using the micropuncture technique, we hypothesized that the early effect of thyroid hormone action is on the potassium permeability of proximal tubular cell membrane. This latter effect would explain the increase in isotonic fluid reabsorption through an increase in the driving force for sodium. Finally, hypothyroid patients have a decrease in glomerular filtration rate and renal plasma flow that are completely reversed by thyroxine administration. On the other hand, hyperthyroid subjects exhibit a significant increase in both parameters.

摘要

甲状腺激素会影响包括心脏和肾脏在内的多个器官的功能。我们使用分离的左乳头肌研究了甲状腺激素对心脏机械和电特性的作用。我们发现单纯甲状腺功能减退会导致收缩和电参数降低,但我们注意到叠加甲状旁腺功能减退会导致收缩动力学和动作电位持续时间显著延长。在肾脏层面,我们已经表明甲状腺激素会影响近端肾小管钠转运,并且这种作用仅部分由甲状腺激素对钠钾ATP酶活性的作用介导。使用微穿刺技术,我们推测甲状腺激素作用的早期效应是对近端肾小管细胞膜的钾通透性。后一种效应可以解释通过增加钠的驱动力导致等渗液重吸收增加。最后,甲状腺功能减退患者的肾小球滤过率和肾血浆流量降低,给予甲状腺素后可完全逆转。另一方面,甲状腺功能亢进患者的这两个参数均显著增加。

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