Visser T J, Lamberts S W
Acta Endocrinol (Copenh). 1981 Apr;96(4):480-3. doi: 10.1530/acta.0.0960480.
In 15 untreated patients with Cushing's disease the regulation of TSH secretion and thyroid function was evaluated. The maximal increment of plasma TSH to TRH was 3.8 +/- 2.2 vs 8.7 +/- 2.9 muU/ml (patients with Cushing's disease vs controls; mean +/- SD; P less than 0.001). Free thyroxine-index was 21.8 +/- 5.2 vs 27.7 +/- 5.0 (P less than 0.001). Plasma T3 1.45 +/- 0.24 vs 1.96 +/- 0.32 nmol/l (P less than 0.001) and reverse T3 0.22 +/- 0.05 vs 0.20 +/- 0.08 nmol/l (N.S.). The maximal TSH increase in response to TRH was inversely correlated with plasma cortisol (P less than 0.05). The maximal increment of TSH to TRH and plasma T4, free T4 index and T3 are reduced in patients with Cushing's disease due to an impaired thyrotroph function. Plasma reverse T3, however, is normal which may be due to a simultaneous decrease in production and degradation.
对15例未经治疗的库欣病患者的促甲状腺激素（TSH）分泌调节及甲状腺功能进行了评估。促甲状腺激素释放激素（TRH）刺激后血浆TSH的最大增加值在库欣病患者中为3.8±2.2μU/ml，而在对照组中为8.7±2.9μU/ml（库欣病患者与对照组相比；均值±标准差；P<0.001）。游离甲状腺素指数在库欣病患者中为21.8±5.2，在对照组中为27.7±5.0（P<0.001）。血浆三碘甲状腺原氨酸（T3）在库欣病患者中为1.45±0.24nmol/l，在对照组中为1.96±0.32nmol/l（P<0.001），而反三碘甲状腺原氨酸（rT3）在库欣病患者中为0.22±0.05nmol/l，在对照组中为0.20±0.08nmol/l（无统计学差异）。TRH刺激后TSH的最大增加值与血浆皮质醇呈负相关（P<0.05）。由于促甲状腺细胞功能受损，库欣病患者中TRH刺激后TSH的最大增加值以及血浆甲状腺素（T4）、游离T4指数和T3均降低。然而，血浆rT3正常，这可能是由于其生成和降解同时减少所致。
