Carpi A, Toscano S
Nuclear Medicine Service, University of Pisa, Italy.
Thyroidology. 1989 Apr;1(1):45-8.
A pharmacological preparation containing L-thyroxine in solution has been tested in man for thyroid substitution or suppression. Twenty-two women and 2 men, aged from 30 to 82 years, with primary hypothyroidism (10) or nodular goiter (14) were treated. Serial clinical and laboratory follow-up evaluations were performed, varying from 1 to 18 months. Five hypothyroid patients and 12 with goiter had not received any previous thyroid hormone medication. Clinical and laboratory euthyroidism was achieved in all 5 hypothyroid patients by a mean weekly L-T4 dose of 580 micrograms. Inhibited or blunted TSH response to TRH was obtained in the subjects with goiter by a mean weekly L-T4 dose of 683 micrograms. The remaining 7 patients (5 hypothyroid and 2 with nodular goiter) received first L-T4 in tablet and then L-T4 in solution. Four of these 7 patients (2 hypothyroid and 2 with nodular goiter), treated with equal doses of the two L-T4 preparations, showed lower basal and stimulated serum TSH concentration during administration of L-T4 in solution. No signs of hyperthyrodism were observed during the treatment. These data indicate that the tested preparation containing L-T4 in solution can be used for thyroid substitution or suppression, and agree with our previous determination of L-T4 content in the preparations indicating an excess of L-T4 in the solution.
一种含有溶液形式L-甲状腺素的药物制剂已在人体中进行甲状腺替代或抑制测试。对22名女性和2名男性进行了治疗,年龄在30至82岁之间,患有原发性甲状腺功能减退症(10例)或结节性甲状腺肿(14例)。进行了为期1至18个月的系列临床和实验室随访评估。5名甲状腺功能减退患者和12名甲状腺肿患者此前未接受过任何甲状腺激素药物治疗。所有5名甲状腺功能减退患者通过平均每周580微克的L-T4剂量实现了临床和实验室甲状腺功能正常。患有甲状腺肿的受试者通过平均每周683微克的L-T4剂量获得了对促甲状腺激素释放激素(TRH)的抑制或减弱的促甲状腺激素(TSH)反应。其余7名患者(5名甲状腺功能减退患者和2名结节性甲状腺肿患者)先接受片剂形式的L-T4治疗,然后接受溶液形式的L-T4治疗。这7名患者中有4名(2名甲状腺功能减退患者和2名结节性甲状腺肿患者)接受了两种L-T4制剂的等量治疗,在接受溶液形式的L-T4治疗期间,其基础和刺激后的血清TSH浓度较低。治疗期间未观察到甲状腺功能亢进的迹象。这些数据表明,测试的含有溶液形式L-T4的制剂可用于甲状腺替代或抑制,并且与我们之前对制剂中L-T4含量的测定结果一致,表明溶液中L-T4过量。