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细胞抑制疗法对患者甲状腺功能状态及血清中甲状腺素结合球蛋白的直接影响。

Direct effects of cytostatic therapy on the functional state of the thyroid gland and TBG in serum of patients.

作者信息

Djurica S N, Plećas V, Milojević Z, Petrović M, Cirović M, Tasovac-Ponomarev D

机构信息

Internal Clinic of Zvezdara Clinical Hospital Centre, Belgrade, Yugoslavia.

出版信息

Exp Clin Endocrinol. 1990 Sep;96(1):57-63. doi: 10.1055/s-0029-1210989.

Abstract

This study analysed the concentrations of thyroid binding globulin (TBG) in the serum as well as the level of triiodothyronine (T3), thyroxine (T4), thyreostimulating hormone (TSH), thyroglobulin (Tg) and T4/TBG coefficient, before therapy and on the fifth day of therapy in 27 patients of both sexes suffering from neoplasia. The patients were treated with cytostatic antibiotics, alkylating agents and podophyllines derivates, by protocol. Serum T3 gains in concentration already after 5 days since the beginning of treatment (from 1.65 +/- 0.20 to 1.73 +/- 0.18 nmol/l), but it is retained within physiological ranges as well as TSH, rT3 and Tg. Thyroxine remains within the permitted ranges, but slightly decreased after therapy (64.00 +/- 11.00 nmol/l, mean +/- SEM) in comparison to the value before (71.00 +/- 19.00), p(F) less than 0.1. A reduction of concentrations in total serum proteins at an average 7.88% was found. The level of inter-alpha globulin, TBG, in patients with proved malignancy is low before therapy (14.97 +/- 4.73 micrograms/l, mean +/- SEM, in males and 14.83 +/- 3.70 in females) but, with application of cytostatics it decreases considerably to the level of 11.68 +/- 4.46 (p less than 0.05) in males and to 13.68 +/- 3.89 in females (NS). In view of these facts, T4/TBG coefficient remains normal and contributes to the maintenance of euthyroid gland function.

摘要

本研究分析了27例患有肿瘤的男女患者治疗前及治疗第5天时血清中甲状腺结合球蛋白(TBG)的浓度以及三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、甲状腺球蛋白(Tg)的水平和T4/TBG系数。按照方案,这些患者接受了细胞毒性抗生素、烷化剂和鬼臼毒素衍生物治疗。自治疗开始5天后血清T3浓度即升高(从1.65±0.20升至1.73±0.18nmol/l),但T3、TSH、反T3(rT3)和Tg均保持在生理范围内。甲状腺素仍在允许范围内,但治疗后与之前的值相比略有下降(64.00±11.00nmol/l,均值±标准误),之前为(71.00±19.00),p(F)小于0.1。发现总血清蛋白浓度平均降低了7.88%。在已证实患有恶性肿瘤的患者中,α-球蛋白间组分(即TBG)的水平在治疗前较低(男性为14.97±4.73μg/l,均值±标准误,女性为14.83±3.70),但使用细胞抑制剂后,男性显著降至11.68±4.46的水平(p小于0.05),女性降至13.68±3.89(无显著性差异)。鉴于这些事实,T4/TBG系数保持正常,有助于维持甲状腺功能正常。

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