Modigliani E, Periac P, Perret G, Hugues J N, Coste T
Ann Med Interne (Paris). 1979;130(5):297-302.
A study of thyroid function was undertaken in 53 patients with chronic alcoholism the following tests were performed: T3 RIA, T4 RIA, T3 test and I.V. TRH-test. The patients were divided into 3 groups according to the degree of liver injury: histologically documented fibrosteatosis (group 1), cirrhosis (group 2); group 3 consisted of severe cirrhosis with coagulation defects precluding liver biopsy. 32 healthy subjects served as controls. Free thyroxine index was normal in the 3 groups of patients; on the contrary, serum T3 RIA was significantly reduced in the 2nd and the 3rd group. The decrease of T3 correlated with the degree of hepatocellular failure. TRH test was almost always normal. If patients are separated into two groups according to their circulating T3 levels, it appears that subjects with low T3 show a TRH-induced increase in TSH lower than in the other group, but not significantly different from normal subjects, suggesting an inadequate hypothalamic reactivity.
对53例慢性酒精中毒患者进行了甲状腺功能研究,进行了以下检查:T3放射免疫分析、T4放射免疫分析、T3试验和静脉注射促甲状腺激素释放激素(TRH)试验。根据肝损伤程度将患者分为3组:组织学证实的纤维脂肪变性(第1组)、肝硬化(第2组);第3组由严重肝硬化伴凝血缺陷而无法进行肝活检的患者组成。32名健康受试者作为对照。3组患者的游离甲状腺素指数均正常;相反,第2组和第3组的血清T3放射免疫分析显著降低。T3的降低与肝细胞衰竭程度相关。TRH试验几乎总是正常的。如果根据患者循环T3水平将其分为两组,似乎T3水平低的受试者TRH诱导的促甲状腺激素(TSH)升高低于另一组,但与正常受试者无显著差异,提示下丘脑反应性不足。