Kaptein E M, Spencer C A, Kamiel M B, Nicoloff J T
J Clin Endocrinol Metab. 1980 Aug;51(2):387-93. doi: 10.1210/jcem-51-2-387.
A 48-h dopamine (DA) infusion (5-7.5 microgram/kg . min) given to six healthy euthyroid males resulted in a suppression of thyroidal iodine release and serum TSH by 44 +/- 3% (P less than 0.01), serum T3 by 9 +/- 2% (P less than 0.01), and serum T4 by 5 +/- 1% (P less than 0.05) below baseline levels, without a significant change in serum rT3 levels. In critically ill patients receiving DA (2-21 microgram/kg . min) for treatment of shock, serum TSH values and T4 production rates were decreased 60% and 56%, respectively, below the respective levels observed in non-DA-treated patients (P less than 0.01). Serial serum samples collected before and during DA therapy revealed a decrease of 52% in TSH (P less than 0.005) and 30% in T4 (P less than 0.05). The finding of a normal serum TSH value during DA theray in a critically ill patient with primary hypothyroidism emphasized the inhibitory potential of DA on TSH secretion. These findings indicate that the prolonged administration of pharmcological doses of DA significantly reduced serum TSH levels and thyroid hormone secretion in normal and critically ill patients, most likely by a direct inhibition of pituitary TSH with a secondary effect on thyroid gland secretion. Therefore, DA therapy probably prolongs and aggravates the low T4 state in critical illness.
对6名甲状腺功能正常的健康男性进行48小时的多巴胺（DA）输注（5 - 7.5微克/千克·分钟），结果导致甲状腺碘释放和血清促甲状腺激素（TSH）抑制44±3%（P<0.01），血清三碘甲状腺原氨酸（T3）抑制9±2%（P<0.01），血清甲状腺素（T4）抑制5±1%（P<0.05），低于基线水平，而血清反三碘甲状腺原氨酸（rT3）水平无显著变化。在接受DA（2 - 21微克/千克·分钟）治疗休克的重症患者中，血清TSH值和T4产生率分别比未接受DA治疗的患者所观察到的相应水平降低了60%和56%（P<0.01）。在DA治疗前和治疗期间采集的系列血清样本显示，TSH降低了52%（P<0.005），T4降低了30%（P<0.05）。在一名原发性甲状腺功能减退的重症患者接受DA治疗期间血清TSH值正常这一发现强调了DA对TSH分泌的抑制潜力。这些发现表明，在正常和重症患者中，长时间给予药理剂量的DA会显著降低血清TSH水平和甲状腺激素分泌，很可能是通过直接抑制垂体TSH并对甲状腺分泌产生继发性影响。因此，DA治疗可能会延长和加重重症患者的低T4状态。
