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短期甲状腺功能减退症中的肾素-血管紧张素系统

The renin-angiotensin system in hypothyroidism of short duration.

作者信息

Elias A N, Kyaw T, Valenta L J, Meshkinpour H

出版信息

Horm Metab Res. 1986 May;18(5):349-51. doi: 10.1055/s-2007-1012312.

Abstract

In six hypothyroid patients (2 male, 4 females, ages 22 through 59 years), plasma renin activity (PRA) and aldosterone (Aldo) were measured when the patients were euthyroid on levothyroxine therapy and one month after the therapy was stopped. Colonic mucosal potential differences were measured during the hypothyroid and euthyroid stages, and catecholamine sensitivity was determined by the blood pressure response to infused norepinephrine. Significant differences were observed in the PRA and aldosterone concentrations which were 4.1 +/- 2.5 ng/ml/h and 9.4 +/- 5.9 ng/dl, respectively in the hypothyroid stage and 6.9 +/- 2.3 ng/ml/h and 15.2 +/- 7.3 ng/dl, respectively when the patients were made euthyroid. The colonic mucosal potential differences (which reflect increased endogenous mineralocorticoid activity), became more electronegative after correction of hypothyroidism (-16.8 +/- 7.5 mV vs -32 +/- 18.2 mV; P less than 0.04) concentrations. Statistically significant decreases in norepinephrine pressor effects were observed in hypothyroid patients when compared to the euthyroid state (7.4 +/- 2.3 vs 10.9 +/- 1.9 micrograms/ng/min; P less than 0.01). It is concluded that patients with hypothyroidism have a hormonal pattern reminiscent of "low renin hypertension", and exhibit decreased sensitivity to catecholamines. Such changes are corrected when the patients become euthyroid on levothyroxine therapy.

摘要

在6例甲状腺功能减退患者(2例男性,4例女性,年龄22至59岁)中,测定了他们在左甲状腺素治疗使甲状腺功能正常时以及治疗停止1个月后的血浆肾素活性(PRA)和醛固酮(Aldo)。在甲状腺功能减退和甲状腺功能正常阶段测量结肠黏膜电位差,并通过输注去甲肾上腺素后的血压反应来确定儿茶酚胺敏感性。观察到PRA和醛固酮浓度存在显著差异,甲状腺功能减退阶段分别为4.1±2.5 ng/ml/h和9.4±5.9 ng/dl,甲状腺功能正常时分别为6.9±2.3 ng/ml/h和15.2±7.3 ng/dl。结肠黏膜电位差(反映内源性盐皮质激素活性增加)在甲状腺功能减退纠正后变得更具负电性(-16.8±7.5 mV对-32±18.2 mV;P<0.04)。与甲状腺功能正常状态相比,甲状腺功能减退患者去甲肾上腺素升压作用有统计学意义的降低(7.4±2.3对10.9±1.9微克/纳克/分钟;P<0.01)。结论是,甲状腺功能减退患者具有类似于“低肾素性高血压”的激素模式,并且对儿茶酚胺的敏感性降低。当患者通过左甲状腺素治疗使甲状腺功能正常时,这些变化会得到纠正。

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