重型地中海贫血患者的甲状腺功能
Thyroid function in thalassaemia major.
作者信息
de Luca F, Melluso R, Sobbrio G, Canfora G, Trimarchi F
出版信息
Arch Dis Child. 1980 May;55(5):389-92. doi: 10.1136/adc.55.5.389.
Serum concentrations of T4, T3, rT3, and TSH were measured by radioimmunoassay in 45 patients suffering from beta-thalassaemia. A TRH stimulation test was performed and the binding capacity of TBG and TBPA for T3 and T4 measured by reverse flow zone electrophoresis in a group of these patients. Mean T4 serum concentration was lower in thalassaemic patients than controls; T3, rT3, TSH levels, and the pituitary response to TRH were normal. TBPA binding capacity for thyroxine was greatly decreased, probably due to iron overload impairing the liver function. The decreased circulating total thyroxine might be explained by the reduced TBPA capacity, serum free thyroid hormone concentration total thyroxine might be explained by the reduced TBPA capacity, serum free thyroid hormone concentration values being normal. It is concluded that thalassaemic children are euthyroid, despite often having low-normal or subnormal thyroxine levels.
采用放射免疫分析法测定了45例β地中海贫血患者血清中T4、T3、反T3（rT3）和促甲状腺激素（TSH）的浓度。对其中一组患者进行了促甲状腺激素释放激素（TRH）刺激试验，并通过反流区带电泳法测定了甲状腺素结合球蛋白（TBG）和甲状腺素结合前白蛋白（TBPA）对T3和T4的结合能力。地中海贫血患者的血清T4平均浓度低于对照组；T3、rT3、TSH水平以及垂体对TRH的反应均正常。TBPA对甲状腺素的结合能力大幅下降，可能是由于铁过载损害肝功能所致。循环总甲状腺素降低可能是由于TBPA能力下降所致，血清游离甲状腺激素浓度值正常。结论是，地中海贫血儿童尽管甲状腺素水平常常处于低正常或低于正常范围，但甲状腺功能正常。
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