非选择性和选择性β-1肾上腺素能受体阻滞剂在甲状腺功能亢进治疗中的应用
Non-selective and selective beta-1-adrenoceptor blocking agents in the treatment of hyperthyroidism.
作者信息
Nilsson O R, Karlberg B E, Kågedal B, Tegler L, Almqvist S
出版信息
Acta Med Scand. 1979;206(1-2):21-5. doi: 10.1111/j.0954-6820.1979.tb13463.x.
Treatment for one month with propranolol or atenolol, a selective beta-1-adrenoceptor blocking agent, was evaluated in 20 hyperthyroid patients. The patients improved to the same extent on either drug, as shown by a clinical diagnostic index. Basal metabolic rate decreased by 11% during both treatments, while it was unchanged in seven untreated hyperthyroid controls. Thyroxine concentration did not change during any treatment. During propranolol treatment T3 decreased from 4.6 to 3.9 nmol/l, while no changes were observed during atenolol treatment or in the control group. No significant changes were seen in free T4, free T3 or rT3 concentrations on any treatment, although free T3 was observed to decrease slightly during propranolol treatment. Thus, the improvement of the clinical symptoms of hyperthyroidism cannot be explained by diminished thyroid hormone concentrations in serum, since the reduction was small during propranolol and absent during atenolol treatment.
对20例甲状腺功能亢进患者使用普萘洛尔或阿替洛尔（一种选择性β1肾上腺素能受体阻滞剂）进行了为期一个月的治疗评估。临床诊断指标显示，两种药物治疗下患者的改善程度相同。两种治疗期间基础代谢率均下降了11%，而7例未经治疗的甲状腺功能亢进对照患者的基础代谢率未发生变化。任何治疗期间甲状腺素浓度均未改变。普萘洛尔治疗期间T3从4.6降至3.9 nmol/l，而阿替洛尔治疗期间及对照组未观察到变化。任何治疗下游离T4、游离T3或反T3浓度均未见显著变化，尽管普萘洛尔治疗期间游离T3略有下降。因此，甲状腺功能亢进临床症状的改善不能用血清甲状腺激素浓度降低来解释，因为普萘洛尔治疗期间降低幅度小，而阿替洛尔治疗期间则无降低。
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