Shigemasa C, Adachi T, Igawa O, Taniguchi S, Mitani Y, Ueta Y, Hori S, Yoshida A, Yamauchi N, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Metabolism. 1988 Jul;37(7):677-82. doi: 10.1016/0026-0495(88)90090-x.
The sequential changes in serum thyroglobulin (Tg), thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3) and thyrotropin (TSH) were evaluated in ten patients on whom partial thyroidectomy for nontoxic nodular goiter had been performed. These changes were compared with those in ten patients who underwent upper abdominal surgery (cholecystectomy) under similar anesthesia, and whose calorie and fluid intake was similar until at least 48 hours after surgery. In agreement with previous reports, marked elevations in serum Tg that reached peak concentration (660 to 1350 ng/mL) at one or two hours after the thyroid incision (mean +/- SD; 787 +/- 304.0 ng/mL and 839 +/- 345.7 ng/mL, respectively) were observed. On the other hand, the significant but minimal increases in serum T4 and FT4 were observed at 24 hours (P less than .001 and P less than .001, respectively), 48 hours (P less than .01 and P less than .001, respectively), and 72 hours (P less than .01 and P less than .01, respectively) after the thyroid incision compared with the level just prior to the thyroid incision. Similarly, serum T3 also increased significantly at 6 to 168 hours after the thyroid incision (P less than .01, P less than .05, P less than .05, P less than .05, and P less than .05, respectively). These increases in serum T4, FT4 and T3 were not observed in the cholecystectomy patients. The mean serum TSH levels at 24 to 72 hours after thyroid incision and those at 6 to 48 hours after the abdominal incision were significantly decreased compared with those before thyroid and abdominal incision, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
对10例因非毒性结节性甲状腺肿接受部分甲状腺切除术的患者,评估了血清甲状腺球蛋白(Tg)、甲状腺素(T4)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)和促甲状腺激素(TSH)的序贯变化。将这些变化与10例在相似麻醉下接受上腹部手术(胆囊切除术)且术后至少48小时热量和液体摄入量相似的患者的变化进行比较。与先前报道一致,观察到甲状腺切开后1或2小时血清Tg显著升高,达到峰值浓度(660至1350 ng/mL)(平均±标准差;分别为787±304.0 ng/mL和839±345.7 ng/mL)。另一方面,与甲状腺切开前的水平相比,甲状腺切开后24小时(分别为P<0.001和P<0.001)、48小时(分别为P<0.01和P<0.001)和72小时(分别为P<0.01和P<0.01)观察到血清T4和FT4有显著但微小的升高。同样,甲状腺切开后6至168小时血清T3也显著升高(分别为P<0.01、P<0.05、P<0.05、P<0.05和P<0.05)。胆囊切除患者未观察到血清T4、FT4和T3的这些升高。甲状腺切开后24至72小时的平均血清TSH水平以及腹部切开后6至48小时的平均血清TSH水平,分别与甲状腺和腹部切开前相比显著降低。(摘要截断于250字)