Madeddu G, Casu A R, Marrosu A, Marras G, Langer M
Clin Endocrinol (Oxf). 1984 Oct;21(4):377-82. doi: 10.1111/j.1365-2265.1984.tb03224.x.
To investigate further the relationship between thyroid hormones and thyroglobulin (TG) secretion, total and free thyroid hormone levels, TSH and its response to TRH and serum TG concentrations were determined in 61 patients with solitary autonomous thyroid nodules. Thyroid function varied widely from euthyroidism to clearcut thyrotoxicosis. Serum TG levels were significantly higher in patients than in normal controls. Individually they were above the normal range (greater than 50 ng/ml) in 95% of the patients, as well as in those with normal total and/or free thyroid hormone levels. Patients with high total and/or free thyroid hormone levels had higher TG concentrations than euthyroid patients. TG concentrations were significantly correlated with FT3 values. They were higher in patients in whom TSH was unresponsive to TRH than in the responsive groups. TG was also slightly higher in patients with hot nodules than in those with warm nodules. These data seem to indicate that TG is secreted along with thyroid hormones in the absence of any stimulatory action. It also is a sensitive index of thyroid hyperfunction. Twenty patients were controlled 6 months after nodulectomy. TG levels, though significantly lower than in the preoperative state, were still higher than in normal subjects. This increase was attributed to persistent hyperthyroidism in two patients only. The observation that the increase in TSH after TRH stimulation in post-operative patients was greater than that found in normal controls led us to believe that in most cases the high TG levels after surgery are due to stimulation of the normal thyroid tissue by rebound TSH secretion.
为了进一步研究甲状腺激素与甲状腺球蛋白（TG）分泌之间的关系，我们测定了61例孤立性自主性甲状腺结节患者的总甲状腺激素和游离甲状腺激素水平、促甲状腺激素（TSH）及其对促甲状腺激素释放激素（TRH）的反应以及血清TG浓度。甲状腺功能从甲状腺功能正常到明显的甲状腺毒症差异很大。患者的血清TG水平显著高于正常对照组。个体而言，95%的患者以及总甲状腺激素和/或游离甲状腺激素水平正常的患者，其TG水平均高于正常范围（大于50 ng/ml）。总甲状腺激素和/或游离甲状腺激素水平高的患者的TG浓度高于甲状腺功能正常的患者。TG浓度与游离三碘甲状腺原氨酸（FT3）值显著相关。TSH对TRH无反应的患者的TG浓度高于有反应的组。热结节患者的TG也略高于温结节患者。这些数据似乎表明，在没有任何刺激作用的情况下，TG与甲状腺激素一起分泌。它也是甲状腺功能亢进的一个敏感指标。20例患者在结节切除术后6个月得到随访。TG水平虽然明显低于术前状态，但仍高于正常受试者。这种升高仅归因于两名患者持续存在的甲状腺功能亢进。术后患者经TRH刺激后TSH升高幅度大于正常对照组，这一观察结果使我们相信，在大多数情况下，术后TG水平升高是由于促甲状腺激素分泌反弹刺激正常甲状腺组织所致。
