Goode A W, Herring A N, Orr J S, Ratcliffe W A, Dudley H A
Ann R Coll Surg Engl. 1981 May;63(3):168-72.
The blood levels of thyrotrophin (TSH), thyroxine (T4), triiodothyronine (T3), and reverse triiodothyronine (rT3) were measured in a group of patients undergoing cholecystectomy and receiving 2000 kcal of glucose daily throughout the study. TSH changes suggested a peroperative peak followed by a fall and subsequent rise. T4 showed no significant changes. T3 fell and rT3 rose postoperatively, with a highly significant fall in the T3/rT3 ratio (p less than 0.001). Surgery and carbohydrate deprivation separately result in similar changes. However, the demonstration of the changes after injury despite adequate carbohydrate intake strongly suggests that they are a primary response to surgery and not a secondary response to the normal consequential fall in caloric and carbohydrate intake. The changes could be an appropriate adaptation to the changed metabolic requirements.
对一组接受胆囊切除术且在整个研究期间每天摄入2000千卡葡萄糖的患者，测定了促甲状腺激素（TSH）、甲状腺素（T4）、三碘甲状腺原氨酸（T3）和反三碘甲状腺原氨酸（rT3）的血药浓度。TSH变化显示出术中达到峰值，随后下降并继而上升。T4无显著变化。术后T3下降，rT3上升，T3/rT3比值显著下降（p小于0.001）。手术和碳水化合物缺乏分别导致类似变化。然而，尽管碳水化合物摄入充足，但损伤后仍出现这些变化，这有力地表明它们是对手术的主要反应，而非对热量和碳水化合物摄入正常相应下降的继发反应。这些变化可能是对代谢需求改变的一种适当适应。
