Bunevicius Robertas, Jakuboniene Neli, Jurkevicius Renaldas, Cernicat Jurate, Lasas Liudvikas, Prange Arthur J
Institute of Endocrinology, Clinic of the Kaunas Medical University, Lithuania.
Endocrine. 2002 Jul;18(2):129-33. doi: 10.1385/ENDO:18:2:129.
It was recently demonstrated that treatment with levorotatory thyroxine (T4) plus triiodothyronine (T3) compared with treatment with T4 alone improves psychologic functioning in hypothyroid patients with thyroid cancer or autoimmune thyroiditis. In the present double-blind crossover study, we again compared the effects of combined thyroid replacement vs monotherapy on psychologic function, endocrine function, cardiovascular function, and body composition. The patients were women who were hypothyroid after thyroidectomy for Graves' disease. The substitution of 10 microg of T3 for 50 microg of T4 caused a statistically significant decrease in free T4 concentration but no significant change in T3 or thyroid-stimulating hormone concentration. Symptoms of hypothyroidism and of hyperthyroidism tended to decrease on a standard symptom scale after combined treatment. With combined hormone replacement, mental state tended to improve on some mood scales but not on cognitive tests. We found alterations in left ventricular diastolic function but no change in body composition after the combined treatment regimen. These preliminary findings in a small group of patients with Graves' disease are consistent with earlier findings that thyroid replacement with T4-T3 combination improves mental functioning.
最近有研究表明，与单独使用左旋甲状腺素（T4）治疗相比，左旋甲状腺素（T4）联合三碘甲状腺原氨酸（T3）治疗可改善患有甲状腺癌或自身免疫性甲状腺炎的甲状腺功能减退患者的心理功能。在本双盲交叉研究中，我们再次比较了联合甲状腺替代疗法与单一疗法对心理功能、内分泌功能、心血管功能和身体成分的影响。患者为因格雷夫斯病行甲状腺切除术后出现甲状腺功能减退的女性。用10微克T3替代50微克T4后，游离T4浓度出现统计学显著下降，但T3或促甲状腺激素浓度无显著变化。在标准症状量表上，联合治疗后甲状腺功能减退和甲状腺功能亢进的症状趋于减轻。联合激素替代治疗后，在一些情绪量表上心理状态趋于改善，但在认知测试中未改善。我们发现联合治疗方案后左心室舒张功能有改变，但身体成分无变化。在一小群格雷夫斯病患者中的这些初步发现与早期研究结果一致，即T4 - T3联合甲状腺替代疗法可改善心理功能。
