Gamstedt A, Kågedal B, Tegler L
Department of Internal Medicine, Orebro Medical Center Hospital, Sweden.
Horm Metab Res. 1988 Jan;20(1):54-6. doi: 10.1055/s-2007-1010747.
38 patients with Graves' disease were treated at random with the glucocorticosteroid betamethasone or with placebo. The daily oral dose was 6.0 mg for the first 5 days, 4.5 mg for the following week, and then 3.0 mg. The serum free triiodothyronine (FT3) concentration decreased within 5 days, while the free thyroxine (FT4) level was reduced first after 3 weeks of betamethasone treatment. The suppressed serum thyrotropin concentration did not change. In the placebo group no significant constant alterations were found in any of the variables studied. The results corroborate that betamethasone decreases FT3 and to a less degree also FT4, which earlier has been indicated by indirect methods, although the mechanisms behind the changes remain to be clarified. Since FT3 is more readily available for the metabolic effects in tissues the rapid striking fall in its concentration is an argument for glucocorticoid treatment in selected patients with severe hyperthyroidism of Graves' disease.
38例格雷夫斯病患者被随机分为两组，分别接受糖皮质激素倍他米松治疗或安慰剂治疗。前5天每日口服剂量为6.0毫克，接下来一周为4.5毫克，然后是3.0毫克。血清游离三碘甲状腺原氨酸（FT3）浓度在5天内下降，而游离甲状腺素（FT4）水平在倍他米松治疗3周后才开始下降。血清促甲状腺素浓度受抑制后未发生变化。在安慰剂组中，所研究的任何变量均未发现显著的持续变化。结果证实，倍他米松可降低FT3，对FT4的降低程度较小，这一点此前已通过间接方法得到证实，尽管变化背后的机制仍有待阐明。由于FT3更容易在组织中发挥代谢作用，其浓度迅速显著下降，这为在某些重度格雷夫斯病甲亢患者中进行糖皮质激素治疗提供了依据。
