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甲状腺功能亢进症患者在β-肾上腺素能阻滞剂治疗期间的血浆甲状腺素、3,3',5-三碘甲状腺原氨酸和3,3',5'-三碘甲状腺原氨酸

Plasma thyroxine, 3,3',5-triiodothyronine and 3,3',5'-triiodothyronine during beta-adrenergic blockade in hyperthyroidism.

作者信息

Verhoeven R P, Visser T J, Doctor R, Hennemann G, Schalekamp M A

出版信息

J Clin Endocrinol Metab. 1977 May;44(5):1002-5. doi: 10.1210/jcem-44-5-1002.

Abstract

Plasma thyroxine (T4), 3,3',5-triiodothyronine (T3) and 3,3',5'-triiodothyronine (rT3) were measured in 16 patients with Graves' disease. Patients were studied under the following conditions: first without any treatment, then, during beta-adrenergic blockade with propranolol, and finally after euthyroidism had been attained by carbimazole. During propranolol T3/T4 ratio decreased, whereas T4 remained unchanged. After carbimazole T3/T4 ratio returned to its pretreatment value. rT3/T4 ratio showed opposite changes. These results suggest that peripheral conversion of T4 into T3 and rT3 in hyperthyroidism is, at least partly, dependent on the functional status of the beta-adrenergic system. Suppressed peripheral conversion of T4 into T3 during beta-adrenergic blocking agents may contribute to the beneficial effects of these drugs in thyrotoxicosis.

摘要

对16例格雷夫斯病患者测定了血浆甲状腺素(T4)、3,3',5-三碘甲状腺原氨酸(T3)和3,3',5'-三碘甲状腺原氨酸(反T3,rT3)。在以下条件下对患者进行研究:首先在未进行任何治疗时,然后在用普萘洛尔进行β-肾上腺素能阻滞期间,最后在通过卡比马唑实现甲状腺功能正常后。在使用普萘洛尔期间,T3/T4比值降低,而T4保持不变。使用卡比马唑后,T3/T4比值恢复到治疗前的值。rT3/T4比值呈现相反的变化。这些结果表明,甲状腺功能亢进时T4向T3和rT3的外周转化至少部分取决于β-肾上腺素能系统的功能状态。β-肾上腺素能阻滞剂作用期间T4向T3的外周转化受抑制可能有助于这些药物对甲状腺毒症的有益作用。

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