Ladenson P W, Goldenheim P D, Cooper D S, Miller M A, Ridgway E C
Am J Med. 1982 Oct;73(4):467-74. doi: 10.1016/0002-9343(82)90323-0.
The metabolic, cardiovascular, renal, and pulmonary responses of 10 hypothyroid patients were studied during the first week of therapy with intravenous levothyroxine (L-thyroxine), 100 micrograms per day. Mean serum thyroxine, triiodothyronine, and reverse triiodothyronine concentrations were normalized within four days. Significant decreases in serum thyrotropin, creatine phosphokinase, and cholesterol levels, and an increase in the basal metabolic rate, were observed. An early cardiovascular response was demonstrated by serial measurement of the mean pre-ejection period (138 to 134 msec, p less than 0.05), its ratio to left ventricular ejection time (0.49 to 0.46, p less than 0.02), and pulse-wave arrival time (236 to 224 msec, p less than 0.05). The mean renal excretion of a water load (four hours) increased (54 to 77 percent, p less than 0.02) by the fourth day. The blunted ventilatory responses to hypercapnea seen in two patients were improved. We conclude that a physiologic replacement dose of intravenous L-thyroxine for one week produces significant responses in organ systems responsible for the common clinical complications of myxedema.
对10例甲状腺功能减退患者在静脉注射左甲状腺素（L-甲状腺素）治疗的第一周进行了代谢、心血管、肾脏和肺部反应的研究，每日剂量为100微克。血清甲状腺素、三碘甲状腺原氨酸和反三碘甲状腺原氨酸的平均浓度在4天内恢复正常。观察到血清促甲状腺激素、肌酸磷酸激酶和胆固醇水平显著下降，基础代谢率升高。通过连续测量平均射血前期（从138毫秒降至134毫秒，p<0.05）、其与左心室射血时间的比值（从0.49降至0.46，p<0.02）以及脉搏波到达时间（从236毫秒降至224毫秒，p<0.05），证实了早期心血管反应。到第4天，水负荷（4小时）的平均肾脏排泄量增加（从54%增至77%，p<0.02）。两名患者中观察到的对高碳酸血症的通气反应迟钝得到改善。我们得出结论，为期一周的生理替代剂量静脉注射L-甲状腺素在负责黏液性水肿常见临床并发症的器官系统中产生了显著反应。
