PULSATILE THYROTROPIN SECRETION IN NONTHYROIDAL ILLNESS
PULSATILE THYROTROPIN SECRETION IN NONTHYROIDAL ILLNESS
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DOI：
10.1210/jc.77.5.1313
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发表时间：
1993-11-01
影响因子：
5.8
通讯作者：
WIERSINGA, WM
中科院分区：
文献类型：
--
作者：
ADRIAANSE, R;ROMIJN, JA;WIERSINGA, WM
本文对16例正常人（A组）和21例非甲状腺疾病（NTI; B组）患者进行了脉动性和夜间TSH分泌的研究。10名患者血浆T-3和T-4值正常（组B-1），11名患者血浆T-3降低，血浆T-4正常或低（组B-2）。NTI患者的平均24小时TSH分泌高于对照组（3.1 +/- 0.7 vs. 1.7 +/- 0.7 mU/L; P < 0.01;平均值+/- SD）。这与NTI患者相对于对照组TSH脉冲幅度增加有关[Desade，0.79 +/- 0.46 vs. 0.44 +/- 0.20 mU/L（P < 0.01）; Cluster，0.64 +/- 0.42 vs. 0.39 +/- 0.20 mU/ L（P < 0.05）]。B1和By亚组之间TSH脉冲幅度无差异。NTI患者和对照组之间TSH脉冲频率没有差异（类似于10脉冲/24小时）。NTI患者24 h TSH浓度与24 h TSH脉冲幅度显著相关，但与24 h TSH脉冲频率无关，NTI患者夜间绝对TSH峰低于对照组（0.6 ± 0.6 mU/L vs.1.0 ± 0.6 mU/L; P < 0.05）。血浆T-3降低的患者（B-2组）的夜间TSH峰较低，与通常的夜间增加的丢失相关，夜间TSH脉冲频率的增加被保留。在6名患者（B-1组2名，B-2组4名）中也观察到了这一点，这些患者完全没有夜间TSH峰。NTI患者夜间TSH分泌的变化与中枢性甲状腺功能减退症相似，提示中枢性甲状腺功能减退症的特征与甲状腺功能正常的病态综合征有关。
Pulsatile and nocturnal TSH secretion was investigated in 16 healthy controls (group A) and 21 patients with nonthyroidal illness (NTI; group B). Ten patients had normal plasma T-3 and T-4 values (group B-1), and 11 patients had decreased plasma T-3 with normal or low plasma T-4 (group B-2). Mean 24-h TSH secretion in NTI patients was higher than that in controls (3.1 +/- 0.7 vs. 1.7 +/- 0.7 mU/L; P < 0.01; mean +/- SD). This was associated with an increased TSH pulse amplitude in NTI patients relative to controls [Desade, 0.79 +/- 0.46 vs. 0.44 +/- 0.20 mU/L (P < 0.01); Cluster, 0.64 +/- 0.42 vs. 0.39 +/- 0.20 mU/ L (P < 0.05)]. There was no difference in TSH pulse amplitude between subgroups Bl and By. TSH pulse frequency was not different between NTI patients and controls (similar to 10 pulses/24 h). The mean 24-h TSH concentration was significantly related to the mean 24-h TSH pulse amplitude but not to the mean 24-h TSH pulse frequency.The absolute nocturnal TSH surge in NTI patients was lower than that in controls (0.6 +/- 0.6 vs. 1.0 +/- 0.6 mU/L; P < 0.05). The lower nocturnal TSH surge in patients with decreased plasma T-3 (group B-2) was associated with a loss of the usual nocturnal increase nocturnal increase in TSH pulse frequency was preserved. This was also observed in the six patients (two in group B-1 and four in group B-2) in whom the nocturnal TSH surge was completely absent. The changes in nocturnal TSH secretion in NTI resemble those found in central hypothyroidism, suggesting that features of central hypothyroidism are involved in the euthyroid sick syndrome.