原发性甲状旁腺功能亢进患者的血清甲状腺激素指标

Serum thyroid hormone indexes in patients with primary hyperparathyroidism.

作者信息

Kaptein E M, Massry S G, Quion-Verde H, Singer F R, Feinstein E I, Nicoloff J T, Sharp C F

出版信息

Arch Intern Med. 1984 Feb;144(2):313-5.

Abstract

Serum total reverse triiodothyronine (rT3) levels are normal in patients with renal diseases with and without renal insufficiency but elevated in nonrenal nonthyroidal illnesses. To evaluate the role of secondary hyperparathyroidism of renal diseases in this difference, serum thyroid hormone levels were studied in 27 patients with primary hyperparathyroidism (PHP) and normal renal function. In PHP, total T3 levels were reduced (118 +/- 6 ng/dL, normal: 147 +/- 3 ng/dL) and correlated with PTH levels. Serum rT3 levels were also decreased (27 +/- 3 ng/dL, normal: 34 +/- 2 ng/dL). Values for serum total thyroxine (T4), T3 uptake ratio, free T4 index, and thyrotrophin were not altered. Serum rT3 levels were increased (63 +/- 13 ng/dL) in patients with hypercalcemia due to malignant neoplasms who had low T3 levels, undetectable PTH and normal renal function. Thus, PTH excess may be the factor responsible for the failure of rT3 levels to increase in PHP and secondary hyperparathyroidism.

摘要

患有或未患有肾功能不全的肾病患者血清总反三碘甲状腺原氨酸（rT3）水平正常，但在非肾性非甲状腺疾病中升高。为了评估肾病继发性甲状旁腺功能亢进在这种差异中的作用，对27例原发性甲状旁腺功能亢进（PHP）且肾功能正常的患者的血清甲状腺激素水平进行了研究。在PHP中，总T3水平降低（118±6 ng/dL，正常：147±3 ng/dL），且与甲状旁腺激素（PTH）水平相关。血清rT3水平也降低（27±3 ng/dL，正常：34±2 ng/dL）。血清总甲状腺素（T4）、T3摄取率、游离T4指数和促甲状腺激素的值未改变。T3水平低、PTH检测不到且肾功能正常的恶性肿瘤所致高钙血症患者血清rT3水平升高（63±13 ng/dL）。因此，PTH过多可能是导致PHP和继发性甲状旁腺功能亢进时rT3水平未能升高的因素。