Hosojima H, Heki N
Nihon Naibunpi Gakkai Zasshi. 1978 Oct 20;54(10):1187-97. doi: 10.1507/endocrine1927.54.10_1187.
In order to obtain more precise information on thyroid functions in renal failure, attempts were made to analyze the Hypothalamo-hypophyseal axis in the regulation of thyroid function. TRH levels and other thyroidal function tests were carried out on sera and urine from patients with renal failure and thyroid diseases. Analysis of TRH in serum and urine was performed by mass fragmentography using a GC-MS combined method. Fifteen out of 28 patients had enlarged thyroid glands, goiter in high prevalence. Thyroid function studies showed low serum thyroxine and triiodothyronine, and high serum thyrotropic hormone levels. Serum and urinary TRH in chronic renal failure were strikingly higher than the other thyroid diseases. There were negative correlations between RIA-T3, Resomat-T4 and serum and urinary TRH levels respectively. There was a negative correlation between serum TSH and serum TRH, but no significant correlation was noticed between serum TSH and urinary TRH levels. There was a high positive correlation between serum TRH and urinary TRH levels. From these findings, it is thought that serum and urinary TRH level values are a more reliable index for the clinical evaluation of thyroid functions in renal failure than the other sample under laboratory data. In patients with chronic hemodialysis, the prevalence of goiter is relatively high, and their thyroid functions are abnormal. However, the cause of the abnormalities is not clear. It is postulated that the possibility of a breakdown of compensation in the Hypothalamo-hypophyseal axis for the regulation of the thyroid function may be seen in chronic renal failure.
为了获取关于肾衰竭患者甲状腺功能的更精确信息，人们尝试分析下丘脑 - 垂体轴对甲状腺功能的调节作用。对患有肾衰竭和甲状腺疾病患者的血清及尿液进行了促甲状腺激素释放激素（TRH）水平检测及其他甲状腺功能测试。采用气相色谱 - 质谱联用的质量碎片分析法对血清和尿液中的TRH进行分析。28例患者中有15例甲状腺肿大，甲状腺肿患病率较高。甲状腺功能研究显示血清甲状腺素和三碘甲状腺原氨酸水平降低，血清促甲状腺激素水平升高。慢性肾衰竭患者血清和尿液中的TRH显著高于其他甲状腺疾病患者。放射免疫分析法检测的T3、树脂吸附法检测的T4与血清及尿液TRH水平之间分别呈负相关。血清促甲状腺激素与血清TRH之间呈负相关，但血清促甲状腺激素与尿液TRH水平之间未发现显著相关性。血清TRH与尿液TRH水平之间呈高度正相关。基于这些发现，人们认为在实验室数据中，血清和尿液TRH水平值对于肾衰竭患者甲状腺功能的临床评估而言，是比其他样本更可靠的指标。在慢性血液透析患者中，甲状腺肿的患病率相对较高，且他们的甲状腺功能异常。然而，异常的原因尚不清楚。据推测，在慢性肾衰竭中可能会出现下丘脑 - 垂体轴对甲状腺功能调节的代偿机制破坏的情况。
