Israel Y, Walfish P G, Orrego H, Blake J, Kalant H
Gastroenterology. 1979 Jan;76(1):116-22.
The relationship between alcoholic liver disease and circulating thyroid hormones was investigated in 124 hospitalized patients treated with placebo or propylthiouracil (PTU) for a maximum of 46 days in a double-blind study. Serum triiodothyronine (T3) levels on admission were significantly (P less than 10(-6) and inversely correlated with the severity of alcoholic liver disease. After hospitalization, changes in T3-levels in patients with low admission T3 significantly correlated (P less than 0.001) with the degree of spontaneous improvement of liver function (placebo group). Treatment with 300 mg of PTU daily (Orrego et al. Gastroenterology 76:105--115, 1979) markedly increased the rate of improvement in severely ill patients with low T3 on admission. In this group, serum T3-levels were also increased after PTU, but this increase did not correlate with the change in the patient's condition. It is suggested that the known inhibitory effect of PTU on peripheral deiodination of T4 to T3 is marked by a more marked improvement in liver function in this group. PTU treatment in this group reduced the free T4-index and increased TSH levels markedly (16%; P less than 0.02) toward levels found in hypothyroidism. PTU did not improve the condition of mildly ill patients with normal admission T3-levels, nor did it alter free T4-index or serum TSH levels in these patients. Serum T3-levels provide a sensitive indicator of the severity of alcoholic liver disease and of its response to conventional treatment. Serum T3-levels also distinguish between a group of patients, in whom low-dose PTU administration results in a beneficial effect, and another group, in whom no therapeutic effect of PTU is observed.
在一项双盲研究中，对124例住院患者进行了酒精性肝病与循环甲状腺激素之间关系的调查，这些患者接受安慰剂或丙硫氧嘧啶（PTU）治疗，最长治疗46天。入院时血清三碘甲状腺原氨酸（T3）水平显著降低（P＜10⁻⁶），且与酒精性肝病的严重程度呈负相关。住院后，入院时T3水平较低的患者T3水平变化与肝功能自发改善程度显著相关（P＜0.001）（安慰剂组）。每日服用300mg PTU治疗（奥雷戈等人，《胃肠病学》76:105 - 115，1979）显著提高了入院时T3水平较低的重症患者的改善率。在该组中，PTU治疗后血清T3水平也有所升高，但这种升高与患者病情变化无关。提示PTU对T4外周脱碘转化为T3的已知抑制作用在该组中表现为肝功能更明显的改善。该组PTU治疗降低了游离T4指数，并使促甲状腺激素（TSH）水平显著升高（16%；P＜0.02），达到甲状腺功能减退患者的水平。PTU对入院时T3水平正常的轻症患者病情无改善作用，也未改变这些患者的游离T4指数或血清TSH水平。血清T3水平是酒精性肝病严重程度及其对传统治疗反应的敏感指标。血清T3水平还可区分出一组低剂量PTU给药有有益效果的患者和另一组未观察到PTU治疗效果的患者。
