Cacciari E, Cicognani A, Pirazzoli P, Bernardi F, Zappulla F, Salardi S, Mazzanti L, Biasini A, Valenti E
Acta Paediatr Scand. 1979 May;68(3):405-9. doi: 10.1111/j.1651-2227.1979.tb05028.x.
Twenty-four euthyroid children with idiopathic pituitary dwarfism were studied. The euthyroid state for seven of these patients was determined by negative physical examinations, normal plasma T4 assays and normal 131I uptakes. For the other children, thyroid function was evaluated with T3 and T4 assays and on the basis of the TRH test. Each of the children was treated with HGH in one of three different ways. The first group (five cases) was given a HGH dose, ranging from 12.4 to 17.2 IU/m2//week. The second and third groups (nine and ten cases, respectively) were treated with 10 and 20 IU/m2/week, respectively. Treatment was carried out for periods ranging from 6 months to 6 years. After no less than 6 months of treatment, and at intervals of 6 months (or some multiple of 6 months) plasma T3 and T4 assays, as well as a TRH test were performed in each patient. In some patients one of the indices was once beyond the upper or lower limit of the normal range (none of the children presented simultaneous abnormal levels of more than one index during the controls). This value, however, returned to within normal limits at the following control. There was no correlation between T3, T4 and TSH with the duration of HGH therapy. There was no significant difference between the groups of children treated with the different HGH doses. These data seem to demonstrate that the risk of inducing an alteration in thyroid function in hypopituitary patients during HGH treatment is very slight, and that the irregularly abnormal thyroid indices observed in some of the children during one of the controls might be an expression of their metabolic status at that moment.
对24例患有特发性垂体性侏儒症的甲状腺功能正常的儿童进行了研究。其中7例患者的甲状腺功能正常状态通过体格检查阴性、血浆T4检测正常和131I摄取正常来确定。对于其他儿童，通过T3和T4检测以及TRH试验来评估甲状腺功能。每个儿童以三种不同方式之一接受生长激素（HGH）治疗。第一组（5例）给予的HGH剂量为12.4至17.2 IU/m2/周。第二组和第三组（分别为9例和10例）分别以10和20 IU/m2/周进行治疗。治疗时间为6个月至6年。在治疗不少于6个月后，每隔6个月（或6个月的倍数）对每位患者进行血浆T3和T4检测以及TRH试验。在一些患者中，其中一项指标曾超出正常范围的上限或下限（在对照期间，没有儿童出现不止一项指标同时异常的情况）。然而，该值在随后的对照中恢复到正常范围内。T3、T4和促甲状腺激素（TSH）与HGH治疗持续时间之间没有相关性。不同HGH剂量治疗的儿童组之间没有显著差异。这些数据似乎表明，在HGH治疗期间，垂体功能减退患者发生甲状腺功能改变的风险非常小，并且在某些儿童的一次对照期间观察到的甲状腺指标不规则异常可能是他们当时代谢状态的一种表现。
