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[肝硬化女性患者的甲状腺激素]

[Thyroid hormones in women with liver cirrhosis].

作者信息

Grün R, Kaffarnik H

出版信息

Klin Wochenschr. 1985 Aug 16;63(16):752-61. doi: 10.1007/BF01733827.

DOI:10.1007/BF01733827
PMID:3930834
Abstract

Basal thyroid hormone levels were measured in 68 women with liver cirrhosis (LC) of different etiology (alcoholic n = 34, posthepatitic B n = 9, PBC n = 5, cryptogenetic n = 18, M. Wilson n = 2). In addition the rise of TSH after 400 micrograms TRH was measured in 23 women with LC and compared with the data obtained from 17 women of a control group. There was no difference of the median T4-concentrations (LC 8.0 micrograms/dl versus 7.2 micrograms/dl) but a significant correlation of T4 to the grade of decompensation of LC. In contrast of T4 there was a marked decrease of T3 in LC-patients (109 ng/dl versus 143 ng/dl) and a rise of reverse T3 (0.21 ng/ml versus 0.13 ng/ml). The decrease of T3 and rise of reverse T3 equally correlated to the severeness of LC. TBG concentrations fell according to the grade of decompensation of LC and T4/TBG-quotient exhibited no difference to the control data (0.51 both). Though basal thyroid hormones and TSH show euthyroidism the significant augmented TSH release after TRH (delta-TSH 7.0 versus 3.2 microU/ml) indicate a status of latent hypothyroidism. In alcoholic cirrhosis the degree of TSH release was much higher than in non alcoholic cirrhosis. Estradiol and estrone levels correlated significantly negatively to T4, T3, estrone negatively to TBG and positively to reverse T3 but not to TSH and TSH release. Otherwise TSH release correlated positively to estradiol. The thyroid status in women with liver cirrhosis does not differ from the thyroid hormone profile found in men with cirrhosis.

摘要

对68例不同病因的肝硬化(LC)女性患者(酒精性肝硬化34例,乙型肝炎后肝硬化9例,原发性胆汁性肝硬化5例,隐源性肝硬化18例,威尔逊病2例)测定了基础甲状腺激素水平。此外,对23例肝硬化女性患者测定了400微克促甲状腺激素释放激素(TRH)后促甲状腺激素(TSH)的升高情况,并与17例对照组女性的数据进行了比较。LC患者的T4中位数浓度(8.0微克/分升对7.2微克/分升)无差异,但T4与LC失代偿程度显著相关。与T4相反,LC患者的T3显著降低(109纳克/分升对143纳克/分升),而反T3升高(0.21纳克/毫升对0.13纳克/毫升)。T3降低和反T3升高均与LC的严重程度相关。甲状腺素结合球蛋白(TBG)浓度随LC失代偿程度下降,T4/TBG比值与对照数据无差异(均为0.51)。尽管基础甲状腺激素和TSH显示甲状腺功能正常,但TRH后TSH释放显著增加(△TSH为7.0对3.2微单位/毫升)表明存在潜在甲状腺功能减退状态。在酒精性肝硬化中,TSH释放程度远高于非酒精性肝硬化。雌二醇和雌酮水平与T4、T3显著负相关,雌酮与TBG负相关,与反T3正相关,但与TSH及TSH释放无关。此外,TSH释放与雌二醇正相关。肝硬化女性的甲状腺状态与肝硬化男性的甲状腺激素谱无差异。

相似文献

1
[Thyroid hormones in women with liver cirrhosis].[肝硬化女性患者的甲状腺激素]
Klin Wochenschr. 1985 Aug 16;63(16):752-61. doi: 10.1007/BF01733827.
2
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Relations between serum levels of TSH, TBG, T4, T3, rT3 and various histologically classified chronic liver diseases.血清促甲状腺激素(TSH)、甲状腺结合球蛋白(TBG)、甲状腺素(T4)、三碘甲状腺原氨酸(T3)、反三碘甲状腺原氨酸(rT3)水平与各种组织学分类的慢性肝病之间的关系。
J Endocrinol Invest. 1980 Oct-Dec;3(4):379-83. doi: 10.1007/BF03349374.
4
Effect of ACTH-stimulated glucocorticoid hypersecretion on the serum concentrations of thyroxine-binding globulin, thyroxine, triiodothyronine, reverse triiodothyronine and on the TSH-response to TRH.促肾上腺皮质激素刺激引起的糖皮质激素分泌过多对血清甲状腺素结合球蛋白、甲状腺素、三碘甲状腺原氨酸、反三碘甲状腺原氨酸浓度及促甲状腺激素对促甲状腺激素释放激素反应的影响。
Acta Med Acad Sci Hung. 1979;36(4):381-94.
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Serum free thyroid hormone concentrations and indices in alcoholic liver cirrhosis, primary biliary cirrhosis and chronic active hepatitis.酒精性肝硬化、原发性胆汁性肝硬化及慢性活动性肝炎患者血清游离甲状腺激素浓度及指数
Acta Endocrinol Suppl (Copenh). 1983;251:21-6.
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Thyroid hormone metabolism in patients with liver cirrhosis, as judged by urinary excretion of triiodothyronine.通过三碘甲状腺原氨酸的尿排泄量判断肝硬化患者的甲状腺激素代谢情况。
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The relationship of serum thyrotropin (TSH) to the thyroid hormones after oral TSH-releasing hormone in patients with preclinical hypothyroidism.亚临床甲状腺功能减退患者口服促甲状腺激素释放激素后血清促甲状腺激素(TSH)与甲状腺激素的关系。
J Clin Endocrinol Metab. 1983 Mar;56(3):449-53. doi: 10.1210/jcem-56-3-449.
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Serum free thyroid hormones in different degrees of hypothyroidism and in euthyroid autoimmune thyroiditis.不同程度甲状腺功能减退及甲状腺功能正常的自身免疫性甲状腺炎患者的血清游离甲状腺激素
Acta Endocrinol (Copenh). 1987 Apr;114(4):559-64. doi: 10.1530/acta.0.1140559.

本文引用的文献

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Serum levels of prolactin, TSH and gonadotrophins following LRH/TRH--double stimulation tests during the menstrual cycle.
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An evaluation of factors which affect circulating thyroid hormone levels in liver diseases.对影响肝脏疾病中循环甲状腺激素水平的因素的评估。
Kaku Igaku. 1981 Jun;18(5):601-8.
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Prolactin and thyrotropin secretin in alcoholic liver cirrhosis: study of the variations induced by TRH, metoclopramide and cimetidine.酒精性肝硬化患者催乳素和促甲状腺激素分泌素:促甲状腺激素释放激素、甲氧氯普胺和西咪替丁诱导的变化研究
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