Reinwein D, Durrer H A, Wiermann H, Löhnert J, von zur Mühlen A
Horm Metab Res. 1976 Sep;8(5):394-9. doi: 10.1055/s-0028-1093622.
In 35 patients with non-toxic goitre, surgically resected thyroid tissue was hydrolyzed with Pronase under anaerobic conditions in the presence of methylmercaptoimidazole. Total iodine, PBI, L-thyroxine (T4-RIA and T4 (D)) as well as triiodothyronine (T3-RIA) were determined in the tissue hydrolysates. The data obtained were compared with T4/T3 ratios in the serum, TRH test and thyroidal 131I uptake before operation. The total iodine, amounted to 112.6 +/- 14.6 ug/g tissue. The T4/T3 ratio was 11.37 +/- 1.80. Using this procedure of tissue hydrolysis and RIA assays for iodothyronines, the yield for T4 and T3 is considerably higher than the one obtained with previous methods. As in animal experiments, evidence was given for human goitre that T3 is predominantly produced first in the case of decreased T4 production. Second in the case of iodine deficiency, and third in cases of increased TSH response after TRH. Patients with a large amount of iodine and T4 in their thyroids have a much smaller increase in serum TSH after TRH than do subjects with a much lower thyroidal T4 concentration. This occurs even though the thyroid hormone levels in serum in these groups are not different. No correlation between thyroidal T4/T3 ratio and serum T4/T3 ration could be demonstrated even under extreme conditions. This finding favors the assumption of a predominant extrathyroidal regulation for T4/T3 ratio in serum.
在35例非毒性甲状腺肿患者中，手术切除的甲状腺组织在厌氧条件下，于甲基巯基咪唑存在的情况下用链霉蛋白酶进行水解。测定组织水解产物中的总碘、蛋白结合碘、L-甲状腺素（T4-RIA和T4（D））以及三碘甲状腺原氨酸（T3-RIA）。将所得数据与术前血清中的T4/T3比值、促甲状腺激素释放激素（TRH）试验及甲状腺131碘摄取情况进行比较。总碘含量为112.6±14.6μg/g组织。T4/T3比值为11.37±1.80。采用这种组织水解方法和碘甲状腺原氨酸放射免疫测定法，T4和T3的产量明显高于以前的方法。如同在动物实验中一样，在人类甲状腺肿中也证实，在T4生成减少的情况下主要首先生成T3；其次在碘缺乏时；第三在TRH后促甲状腺激素（TSH）反应增强的情况下。甲状腺中碘和T4含量高的患者，TRH后血清TSH的升高幅度比甲状腺T4浓度低得多的患者小得多。即使这些组血清中的甲状腺激素水平并无差异，这种情况仍会出现。即使在极端条件下，也未证实甲状腺T4/T3比值与血清T4/T3比值之间存在相关性。这一发现支持血清中T4/T3比值主要受甲状腺外调节的假设。
