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皮质类固醇与甲状腺功能。口服和静脉给药后对血浆容量、甲状腺激素及甲状腺激素结合蛋白的不同影响。

Corticosteroids and thyroid function. Different effects on plasma volume, thyroid hormones and thyroid hormone-binding proteins after oral and intravenous administration.

作者信息

Gamstedt A, Järnerot G, Kågedal B, Söderholm B

出版信息

Acta Med Scand. 1979;205(5):379-83.

PMID:108922
Abstract

The influence of glucocorticosteroids on plasma volume, thyroid hormones and thyroid hormone-binding proteins was studied in 17 patients. Plasma volume was not affected either by i.v. beta-methasone (6 mg daily) or by oral prednisolone (45--180 mg daily) given for 5 days. The serum T3 concentration decreased while rT3 increased independently of the route of administration of corticosteroids. Serum T4 concentration decreased after i.v. but not after oral administration of corticosteroids. Oral steroids as compared to i.v. increased the 125I-triiodothyronine uptake test value. The serum TBG concentration decreased independently of the route of administration, while the serum TBPA concentration increased after oral corticosteroids but was unchanged after i.v. treatment. The serum TSH concentration was slightly reduced. About half of the patients were given both corticosteroids and nutrition i.v. and the other half were given all treatment by mouth. The part played by the route of administration of corticosteroids and calories, respectively, cannot be evaluated at present but these factors seem to be of importance.

摘要

对17例患者研究了糖皮质激素对血浆容量、甲状腺激素及甲状腺激素结合蛋白的影响。静脉注射β-甲泼尼龙(每日6mg)或口服泼尼松龙(每日45 - 180mg),连续给药5天,均未影响血浆容量。血清T3浓度降低,而反T3升高,且与糖皮质激素的给药途径无关。静脉注射糖皮质激素后血清T4浓度降低,但口服给药后未降低。与静脉注射相比,口服类固醇使125I-三碘甲状腺原氨酸摄取试验值升高。血清TBG浓度降低,且与给药途径无关,而血清TBPA浓度在口服糖皮质激素后升高,但静脉注射治疗后无变化。血清TSH浓度略有降低。约一半患者静脉注射糖皮质激素并补充营养,另一半患者则全部经口给予治疗。目前尚无法评估糖皮质激素给药途径和热量摄入分别所起的作用,但这些因素似乎很重要。

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