Dudenhausen J W
Geburtshilfe Frauenheilkd. 1984 Dec;44(12):777-80. doi: 10.1055/s-2008-1036518.
Stimulation of the surfactant production in foetal lung cells by thyroxine has been shown in experiments on animals. In humans, too, thyroxine instilled intra-amnially should increase lung maturity. Therefore, amniotic fluid samples were taken from 22 women before the 35th week of gestation before instilling 500 micrograms levothyroxine and then during labour, and blood samples were taken half an hour and also 24 hours after instillation of thyroxine into the amniotic fluid and during labour. The concentration of thyroxine, triiodinethyronine and reversed triiodinethyronine were measured radioimmunologically in the amniotic fluid samples and blood samples, and the lecithin concentration was also determined enzymatically in the amniotic fluid samples. The occurrence of cases of membrane syndrome in the examined group, and the foetal heart rate were subsequently determined after thyroxine had been administered. The results showed that the foetus resorbed the thyroxine administered intra-amnially and--in a manner typical of foetal metabolism--converted it by preference to rT3. The thyroxine dosage leads to only a temporary increase in foetal thyroid gland hormones. The thyroxine given intra-amnially is not absorbed in considerable amounts by the mother. The lecithin content of the amniotic fluid was significantly increased after a dose of thyroxine, possibly a reversible increase. The membrane syndrome rate laid below the expected number; in 5 of the 22 cases a foetal tachycardia was observed about 2 days after thyroxine administration.
动物实验已表明,甲状腺素可刺激胎儿肺细胞产生表面活性剂。在人类中,羊膜腔内注入甲状腺素也应能提高肺成熟度。因此,在妊娠35周前,从22名妇女身上采集羊水样本,然后注入500微克左甲状腺素,之后在分娩期间再次采集羊水样本;在向羊膜腔内注入甲状腺素后半小时、24小时以及分娩期间采集血样。采用放射免疫法测定羊水样本和血样中甲状腺素、三碘甲状腺原氨酸和反三碘甲状腺原氨酸的浓度,同时采用酶法测定羊水样本中的卵磷脂浓度。在给予甲状腺素后,随后确定受检组中膜综合征病例的发生情况以及胎儿心率。结果显示,胎儿吸收了羊膜腔内注入的甲状腺素,并以典型的胎儿代谢方式,优先将其转化为反三碘甲状腺原氨酸。甲状腺素剂量仅导致胎儿甲状腺激素暂时升高。羊膜腔内给予的甲状腺素不会被母亲大量吸收。给予一剂甲状腺素后,羊水的卵磷脂含量显著增加,可能是一种可逆性增加。膜综合征发生率低于预期数量;在22例病例中有5例在给予甲状腺素后约2天观察到胎儿心动过速。