Smals A G, Kloppenborg P W, Hoefnagels W H, Drayer J I
Acta Endocrinol (Copenh). 1979 Apr;90(4):577-84. doi: 10.1530/acta.0.0900577.
Four weeks high dose spironolactone treatment (Aldactone Searle, 100 mg q. i. d.) significantly enhanced the TSH (delta max. 8.5 +/- 4.1 vs. 4.6 +/- 3.1 microunits/ml, P less than 0.05) and T3 (delta max. 32 +/- 27 vs. 11 +/- 16 ng/100 ml, P less than 0.05) responses to an intravenous TRH/LH-RH bolus injection in 6 eumenorrhoeic euthyroid hypertensive women, without affecting basal serum TSH, T3 or T4 levels or the basal and stimulated LH, FSH and prolactin values (P greater than 0.10). The mean serum testosterone, 17-hydroxyprogesterone and oestradiol levels were also similar before and during therapy. Spironolactone, possibly by virtue of its antiandrogenic action, may exert its enhancing effect on pituitary-thyroid function by modulating the levels of receptors for TRH in the thyrotrophs or by altering the T3 receptor in the pituitary permitting a greater response to TRH.
对6名月经正常、甲状腺功能正常的高血压女性进行为期四周的高剂量螺内酯治疗（安体舒通，100毫克，每日4次），显著增强了静脉注射促甲状腺激素释放激素/促黄体生成激素释放激素推注后的促甲状腺激素（最大变化值8.5±4.1对4.6±3.1微单位/毫升，P<0.05）和三碘甲状腺原氨酸（最大变化值32±27对11±16纳克/100毫升，P<0.05）反应，而不影响基础血清促甲状腺激素、三碘甲状腺原氨酸或甲状腺素水平，以及基础和刺激后的促黄体生成素、促卵泡生成素和催乳素值（P>0.10）。治疗前和治疗期间的平均血清睾酮、17-羟孕酮和雌二醇水平也相似。螺内酯可能凭借其抗雄激素作用，通过调节促甲状腺细胞中促甲状腺激素释放激素受体的水平，或改变垂体中的三碘甲状腺原氨酸受体，从而对垂体-甲状腺功能产生增强作用，使对促甲状腺激素释放激素产生更大反应。
