下丘脑-垂体-甲状腺轴

The hypothalamic-pituitary-thyroid axis.

作者信息

Carlson H E, Hershman J M

出版信息

Med Clin North Am. 1975 Sep;59(5):1045-53. doi: 10.1016/s0025-7125(16)31955-1.

DOI:10.1016/s0025-7125(16)31955-1

Abstract

Although recent investigations have contributed greatly to our understanding of the function and regulation of the hypothalamic-pituitary-thyroid axis, much remains unclear. The influence of suprahypothalamic areas of the brain on hypothalamic function, the nature of thyroid hormone feedback on the hypothalamus, and the physiologis sugnificance of prolactin release by TRH are all topics requiring further study. The extensive experience which has been accululated in the use of TRH as a diagnostic tool has led to its acceptance as a safe, convenient, rapid method of assessment of pituitary and thyroid function. It appears that TRH testing is useful in evaluation of pituitary TSH and prolactin reserve in patients with pituitary lesions; in the differentiation of pituitary and hypothalamic causes of hypothyroidism; in diagnosis of euthyroid Graves' disease; in the evaluation of the adequacy of TSH suppression in thyroid hormone therapy of nodular goiter; and possibly in the diagnosis of mild primary hypothyroidism.

摘要

尽管最近的研究极大地增进了我们对下丘脑 - 垂体 - 甲状腺轴功能及调节的理解，但仍有许多尚不清楚之处。大脑下丘脑以上区域对下丘脑功能的影响、甲状腺激素对下丘脑反馈的本质以及促甲状腺激素释放激素（TRH）释放催乳素的生理意义，都是需要进一步研究的课题。在将TRH用作诊断工具方面积累的丰富经验，已使其被认可为一种安全、便捷、快速评估垂体和甲状腺功能的方法。看来，TRH检测在评估垂体病变患者的垂体促甲状腺激素（TSH）和催乳素储备、鉴别垂体性和下丘脑性甲状腺功能减退的病因、诊断甲状腺功能正常的格雷夫斯病、评估结节性甲状腺肿甲状腺激素治疗中TSH抑制的充分性以及可能在诊断轻度原发性甲状腺功能减退方面是有用的。