Brinckmeyer L M, Worm A M, Nissen N I
Acta Med Scand. 1977;202(6):475-80. doi: 10.1111/j.0954-6820.1977.tb16868.x.
Thyroid function was studied in 36 patients with various stages of malignant lymphoma. Stage IVB patients exhibited characteristic changes in thyroid biochemistry in the form of lowered triiodothyronine (T3) and elevated free thyroxine (FT4), but normal thyroxine. Moreover, the concentration of thyroxine-binding prealbumin and albumin was lowered, whereas thyroxine-binding globulin was normal. Thyroid-stimulating hormone was slightly elevated but showed a normal increase after administration of thyrotrophin-releasing hormone. Patients with less extensive disease differed only slightly from the controls. The results agree with previous studies of patients suffering from other chronic diseases. The mechanisms underlying the hormonal changes have been only partially elucidated. When investigating patients with disseminated malignant disease for thyroid disease, the above mentioned changes in thyroid biochemistry must be borne in mind. Single analyses of FT4 and T3 may give rise to a false assumption of hyper- or hypothyroid states in patients who are in fact euthyroid.
对36例处于不同阶段的恶性淋巴瘤患者的甲状腺功能进行了研究。IVB期患者甲状腺生化指标出现特征性变化,表现为三碘甲状腺原氨酸(T3)降低、游离甲状腺素(FT4)升高,但甲状腺素正常。此外,甲状腺素结合前白蛋白和白蛋白浓度降低,而甲状腺素结合球蛋白正常。促甲状腺激素略有升高,但在给予促甲状腺激素释放激素后呈正常升高。病情较轻的患者与对照组仅有轻微差异。这些结果与先前对其他慢性疾病患者的研究一致。激素变化的潜在机制仅得到部分阐明。在对患有播散性恶性疾病的患者进行甲状腺疾病调查时,必须牢记上述甲状腺生化指标的变化。对FT4和T3进行单次分析可能会导致对实际上甲状腺功能正常的患者出现甲状腺功能亢进或减退状态的错误假设。