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甲状腺全切除术后血清促甲状腺激素、甲状腺素和三碘甲状腺原氨酸的变化(作者译)

[Changes in serum thyrotropin, thyroxine and triiodothyronine after complete thyroidectomy (author's transl)].

作者信息

Tamai H, Suematsu H, Takahashi H, Aoki H, Matsuzuka F, Tanaka T, Kuma K, Inoue K, Nagataki S

出版信息

Nihon Naibunpi Gakkai Zasshi. 1978 Jul 20;54(7):891-7. doi: 10.1507/endocrine1927.54.7_891.

Abstract

Changes in serum TSH, T4 and T3 concentrations after complete thyroidectomy were observed for 4 weeks in 9 euthyroid patients with thyroid carcinoma. Completeness of the thyroidectomy was confirmed by a 131 I scintigram performed one or two months after the operation. Serum TSH levels rose progressively during the 4 weeks of observation, and a significant increase was noticed as early as 3 days after the thyroidectomy. Serum T4 and T3 concentrations decreased significantly 3 days and 18 hrs, respectively, after the thyroidectomy. A sharp decrease in serum T3 concentrations within 18 hrs without a significant change in serum T4 levels and possibly without a significant change in the amount of T3 derived from T4 suggests that the amount of T3 secreted from the thyroid is large enough to affect serum T3 concentrations. The rate of decrease of serum T4 (t 1/2: 16 days) or serum T3 (t 1/2: 23 days) after the 3rd day of the thyroidectomy was much slower than the rate of disappearance of labeled T4 or T3 reported previously. The slow decrease rate of serum T3 is probably due to the conversion of T4 to T3 in peripheral tissues, and that of serum T4 may be due to either the decrease in T4 disposal rate in hypothyroidism or due to the release of T4 from peripheral tissues to serum.

摘要

对9例甲状腺癌的甲状腺功能正常患者进行了全甲状腺切除术后4周的血清促甲状腺激素(TSH)、甲状腺素(T4)和三碘甲状腺原氨酸(T3)浓度变化观察。甲状腺切除的完整性在术后1至2个月通过131I闪烁扫描得以证实。在观察的4周内血清TSH水平逐渐升高,早在甲状腺切除术后3天就观察到显著升高。甲状腺切除术后3天和18小时,血清T4和T3浓度分别显著下降。血清T3浓度在18小时内急剧下降,而血清T4水平无显著变化,且可能源自T4的T3量也无显著变化,这表明甲状腺分泌的T3量足以影响血清T3浓度。甲状腺切除术后第3天之后血清T4(半衰期:16天)或血清T3(半衰期:23天)的下降速率比先前报道的标记T4或T3的消失速率要慢得多。血清T3下降速率缓慢可能是由于外周组织中T4向T3的转化,而血清T4下降速率可能是由于甲状腺功能减退时T4清除率降低或由于外周组织中T4释放到血清中。

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