Jaffiol C, Baldet L, Robin M, Papachristou C, Lapinski H, Mirouze J
Horm Metab Res. 1977 Jan;9(1):73-81. doi: 10.1055/s-0028-1093588.
Ninety five patients with Graves' disease were studied before and at three months intervals after antithyroid drugs (ATD) (31 cases) or radioiodine (64 cases) therapy until recovery. Before treatment, the T4 maxima binding capacity of TBPA was significantly decreased 253.5 +/- 11.4 mug/100 ml)(mean + se) (control values: 287 +/- 10.4 mug/100 ml) (alpha = 0.04), especially in 53.7% of patients (m = 177 +/- 8 mug/100 ml). The mean of TBG (m = 20.7 +/- 0.9 mug/100 ml) was not different from euthyroid subjects (m = 19.7 +/- 1.7 mug/100 ml) except in 51.2% of patients who had a low TBG (m = 14.3 +/- 1.1 mug/100 ml). An inverse linear correlation was found between TBG-DFT4 (alpha = 0.05) and DF T 3 (alpha = 0.002), TBPA-log DF T4 (alpha = 0.05) but not between TBG and TBPA. The physiological relationship between DFT3, DFT4, TT3, TBG and TBPA was studied in vitro; after adding increased quantities of T4 to a pool of sera collected from eu, hypo or hyperthyroid patients, DFT4, DFT3, FT3 index increased in linear positive relationship with TT4 concentrations, the kinetic of this phenomena was inversely correlated with T4 maximal binding capacity of TBG or TBPA for T4. Addition of T3 to the same sera did not show any effect on the previous parameters. DFT3 depended on the level of T4 in serum more than T3 concentration and was in inverse relationship with the maximal binding capacity of TBG. This data might explain the paradoxal normal or slightly increased values of DFT3 found in T3 thyrotoxicosis. In patients treated with ATD or radioiodine, TBPA but not TBG increased significantly on year after. However, in subjects with an initial very low TGB or TBPA, this phenomenon occurred on the third month after radioiodine or ATD. During the same period, DF T4 and DF T3 were inversely correlated to TBG and TBPA. In conclusion, important changes in T4 binding proteins and free fractions of thyroid hormones were observed in Graves' disease but were corrected by antithyroid therapy. All these data were in good agreement with the normalisation of thyroid function.
对95例格雷夫斯病患者在抗甲状腺药物（ATD）（31例）或放射性碘（64例）治疗前及治疗后每隔三个月进行研究，直至康复。治疗前，甲状腺素结合前白蛋白（TBPA）的T4最大结合能力显著降低（253.5±11.4μg/100ml）（平均值±标准误）（对照值：287±10.4μg/100ml）（α=0.04），尤其是53.7%的患者（m=177±8μg/100ml）。甲状腺素结合球蛋白（TBG）的平均值（m=20.7±0.9μg/100ml）与甲状腺功能正常的受试者（m=19.7±1.7μg/100ml）无差异，但51.2%的患者TBG较低（m=14.3±1.1μg/100ml）。发现TBG-DFT4（α=0.05）与DFT3（α=0.002）、TBPA-log DFT4（α=0.05）之间呈负线性相关，但TBG与TBPA之间无相关性。在体外研究了DFT3、DFT4、TT3、TBG和TBPA之间的生理关系；向从甲状腺功能正常、减退或亢进患者采集的血清池中添加增加量的T4后，DFT4、DFT3、FT3指数与TT4浓度呈线性正相关增加，这种现象的动力学与TBG或TBPA对T4的T4最大结合能力呈负相关。向相同血清中添加T3对先前参数无任何影响。DFT3更多地取决于血清中T4的水平而非T3浓度，并且与TBG的最大结合能力呈负相关。这些数据可能解释了在T3甲状腺毒症中发现的DFT3矛盾的正常或略有升高的值。在用ATD或放射性碘治疗的患者中，一年后TBPA显著增加，而TBG未增加。然而，在初始TBG或TBPA非常低的受试者中，这种现象在放射性碘或ATD治疗后的第三个月出现。在同一时期，DFT4和DFT3与TBG和TBPA呈负相关。总之，在格雷夫斯病中观察到甲状腺激素结合蛋白和游离部分的重要变化，但通过抗甲状腺治疗得以纠正。所有这些数据与甲状腺功能的正常化一致。
