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原发性甲状腺功能减退症患者的血清肌红蛋白及左甲状腺素治疗的影响

Serum myoglobin in primary hypothyroidism and effect of L-thyroxine therapy.

作者信息

Martino E, Sardano G, Vaudagna G, Bambini G, Breccia M, Motz E, Ciampi M, Baschieri L, Pinchera A

出版信息

J Nucl Med. 1982 Dec;23(12):1088-92.

PMID:7143091
Abstract

Serum myoglobin (Mb) concentrations have been measured by radioimmunoassay in normal subjects, in hypothyroid patients examined 20 days after withdrawal of thyroid hormone therapy ("short-term" hypothyroidism), and in untreated hypothyroids ("long-term" hypothyroidism). In "short-term" hypothyroids, serum Mb levels were significantly higher (p less than 0.01) than those observed in normal controls, although only a minority or patients showed elevated Mb levels. In "long-term" hypothyroids, serum Mb concentrations were significantly higher than that found in normal controls (p less than 0.0001) and in "short-term" hypothyroids (p less than 0.001). In "long-term" hypothyroidism a significant inverse correlation was found between serum thyroid hormones and Mb, whereas no similar correlation was observed in "short-term" hypothyroidism. The administration of progressively increasing doses of L-T4 untreated hypothyroids was followed by normalization of serum Mb, but serum TSH levels still remained elevated. These data indicate that the duration and the severity of hypothyroidism are important factors in the rise of serum Mb, and that the normalization of serum Mb is faster than that of serum TSH and requires less L-T4 than that needed for normal TSH secretion.

摘要

已通过放射免疫分析法测定了正常受试者、在停止甲状腺激素治疗20天后接受检查的甲状腺功能减退患者(“短期”甲状腺功能减退)以及未经治疗的甲状腺功能减退患者(“长期”甲状腺功能减退)的血清肌红蛋白(Mb)浓度。在“短期”甲状腺功能减退患者中,血清Mb水平显著高于正常对照组(p<0.01),尽管只有少数患者Mb水平升高。在“长期”甲状腺功能减退患者中,血清Mb浓度显著高于正常对照组(p<0.0001)和“短期”甲状腺功能减退患者(p<0.001)。在“长期”甲状腺功能减退中,血清甲状腺激素与Mb之间存在显著的负相关,而在“短期”甲状腺功能减退中未观察到类似的相关性。对未经治疗的甲状腺功能减退患者逐渐增加L-T4剂量后,血清Mb恢复正常,但血清促甲状腺激素(TSH)水平仍保持升高。这些数据表明,甲状腺功能减退的持续时间和严重程度是血清Mb升高的重要因素,并且血清Mb的恢复正常比血清TSH更快,所需的L-T4比正常TSH分泌所需的量更少。

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