Ridgway E C, Weintraub B D, Maloof F
J Clin Invest. 1974 Mar;53(3):895-903. doi: 10.1172/JCI107630.
Metabolic clearance (MCR) and production rates (PR) of human thyrotropin (hTSH) were determined by the constant infusion to equilibrium method 57 times in 55 patients. 16 control patients had a mean hTSH MCR of 50.7 ml/min. The mean hTSH MCR was significantly (P < 0.02) higher in 19 euthyroid men (51.6 ml/min) than in 12 euthyroid women (43.0 ml/min), but this apparent sex difference disappeared when the MCR were corrected for surface area, 25.8 (men) versus 25.2 ml/min per m(2) (women). Hypothyroid patients had significantly (P < 0.005) lower hTSH MCR (30.9 ml/min), and hyperthyroid patients had significantly (P < 0.05) higher hTSH MCR (60.9 ml/min) than controls. The hTSH MCR in patients with "decreased thyroid reserve" (40.9 ml/min), hyperfunctioning thyroid nodule (53.8 ml/min), and "empty sella syndrome" (46.6 ml/min) were not significantly different from controls. The mean hTSH PR in controls (104.3 mU/day) was significantly (P < 0.005) different from that in patients with "decreased thyroid reserve" (956 mU/day), hypothyroidism (4,440 mU/day), hyperthyroidism (< 43.9 mU/day) and a hyperfunctioning thyroid nodule (< 38.7 mU/day). In primary hypothyroidism intravenous triiodothyronine therapy (50 mug/day) for 10 days decreased the hTSH PR (from 4,244 to 2,461 mU/day) before changes in the hTSH MCR (from 33.1 to 33.7 mU/day) were observed. These studies have demonstrated that changes in the serum concentration of hTSH are mainly due to altered pituitary hTSH secretion with only a minor contribution from the change in hTSH MCR.
采用持续输注至平衡法对55例患者进行了57次人促甲状腺激素（hTSH）代谢清除率（MCR）和生成率（PR）的测定。16例对照患者的hTSH平均MCR为50.7 ml/分钟。19例甲状腺功能正常男性的hTSH平均MCR（51.6 ml/分钟）显著高于（P<0.02）12例甲状腺功能正常女性（43.0 ml/分钟），但当MCR校正体表面积后，这种明显的性别差异消失，男性为25.8，女性为25.2 ml/分钟每平方米。甲状腺功能减退患者的hTSH MCR显著降低（P<0.005，30.9 ml/分钟），甲状腺功能亢进患者的hTSH MCR显著高于（P<0.05）对照组（60.9 ml/分钟）。“甲状腺储备降低”患者（平均MCR为40.9 ml/分钟）、甲状腺功能亢进性腺瘤患者（53.8 ml/分钟）和“空蝶鞍综合征”患者（46.6 ml/分钟）的hTSH MCR与对照组无显著差异。对照组的hTSH平均PR（104.3 mU/天）与“甲状腺储备降低”患者（956 mU/天）、甲状腺功能减退患者（4440 mU/天）、甲状腺功能亢进患者（<43.9 mU/天）和甲状腺功能亢进性腺瘤患者（<38.7 mU/天）有显著差异（P<0.005）。在原发性甲状腺功能减退症患者中，静脉注射三碘甲状腺原氨酸治疗（50μg/天，共10天）使hTSH PR降低（从4244降至2461 mU/天），而此时尚未观察到hTSH MCR的变化（从33.1降至33.7 ml/分钟）。这些研究表明，hTSH血清浓度的变化主要是由于垂体hTSH分泌改变所致，hTSH MCR的变化仅起较小作用。
