Brooks M H, Waldstein S S
Ann Intern Med. 1980 Nov;93(5):694-7. doi: 10.7326/0003-4819-93-5-694.
Total serum thyroxine concentrations, the dialyzable fractions of total thyroxine, and absolute free thyroxine concentrations were measured in six patients with thyroid storm, in 15 patients with uncomplicated thyrotoxicosis, and in 19 normal subjects. Total thyroxine concentrations were similar in both thyrotoxic groups. However, the mean dialyzable fraction of thyroxine and the mean free thyroxine concentration was significantly higher in patients with thyroid storm than in patients with uncomplicated thyrotoxicosis (0.060 +/- 0.017% versus 0.026 +/- 0.006% and 10.9 +/- 3.8 ng/dL versus 4.7 +/- 1.4 ng/dL, respectively). These findings suggest that events precipitating thyroid storm may act with thyrotoxicosis to decrease thyroxine binding markedly and result in a sharp increase in free thyroxine concentration. These phenomena may play a role in the pathogenesis of thyroid storm.
对6例甲状腺危象患者、15例无并发症的甲状腺毒症患者和19名正常受试者测定了血清总甲状腺素浓度、总甲状腺素的可透析部分以及游离甲状腺素的绝对浓度。两个甲状腺毒症组的总甲状腺素浓度相似。然而，甲状腺危象患者甲状腺素的平均可透析部分和平均游离甲状腺素浓度显著高于无并发症的甲状腺毒症患者（分别为0.060±0.017%对0.026±0.006%和10.9±3.8 ng/dL对4.7±1.4 ng/dL）。这些发现表明，引发甲状腺危象的事件可能与甲状腺毒症共同作用，显著降低甲状腺素结合，并导致游离甲状腺素浓度急剧升高。这些现象可能在甲状腺危象的发病机制中起作用。
