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无症状自身免疫性甲状腺炎中的甲状腺激素储备

Thyroid hormone reserve in asymptomatic autoimmune thyroiditis.

作者信息

Deboel S, Bonnyns M, Jonckheer M, Buydens P, Smitz J, Finne E, Vanhaelst L

出版信息

Acta Endocrinol (Copenh). 1987 Mar;114(3):336-9. doi: 10.1530/acta.0.1140336.

Abstract

Basal (B) and peak (P) serum levels of thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3), free triiodothyronine (FT3), and TSH were measured before and after oral TRH (40 mg) administration in 79 subjects affected with asymptomatic autoimmune thyroiditis (AAT) and in 69 normal subjects. The area under the curve (AUC) and peak values of T4, FT4, T3 and FT3 were considered as parameters of thyroid hormone reserve. Intrathyroidal iodine (ITI) was measured by the X-ray fluorescence method. The AAT subjects were divided into three groups on the basis of their basal and peak TSH values. In group I, these parameters were similar to those in the normal controls; in group II, basal TSH remained normal but peak TSH was significantly increased, and in group III both values were significantly increased. Group I differed from the controls by a decrease in P FT4 and AUC FT4, whereas in groups II and III B FT4 was also significantly lowered. T3 levels were similar in all groups except in group III, in whom they dropped. ITI was already lower in group I than in the controls. Its decline went further in groups II and III. An inverse correlation with significant r values was evidenced between log B and P TSH on one hand and log B FT4, P FT4 and AUC FT4 on the other. When group III was excluded, log P TSH was positively correlated with log B T3, P T3, AUC T3, and AUC F T3.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在79例无症状自身免疫性甲状腺炎(AAT)患者和69例正常受试者中,口服促甲状腺激素释放激素(TRH,40mg)前后分别测定血清甲状腺素(T4)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)以及促甲状腺激素(TSH)的基础值(B)和峰值(P)。将T4、FT4、T3和FT3的曲线下面积(AUC)及峰值视为甲状腺激素储备参数。采用X射线荧光法测定甲状腺内碘(ITI)。根据基础TSH值和峰值TSH值,将AAT患者分为三组。I组中这些参数与正常对照组相似;II组基础TSH保持正常,但峰值TSH显著升高;III组两个值均显著升高。I组与对照组相比,P FT4和AUC FT4降低,而II组和III组中B FT4也显著降低。除III组T3水平下降外,其他组T3水平相似。I组ITI已低于对照组,II组和III组下降更明显。一方面,log B TSH和P TSH与另一方面log B FT4、P FT4和AUC FT4之间存在显著r值的负相关。排除III组后,log P TSH与log B T3、P T3、AUC T3和AUC F T3呈正相关。(摘要截取自250词)

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