摘要
长期以来国内外学者对于甲状腺功能减退症的替代治疗是采用标准化的左旋甲状腺素(L evothyroxine,L- T4 )替代治疗方案。然而最近的临床研究表明标准化的L- T4替代治疗不能完全缓解患者的症状,而应用L- T4 /T3的方案替代治疗才能完全缓解患者的症状。进一步的动物实验研究也证实单纯的L- T4治疗不能使甲状腺切除鼠血清中以及大多数组织中T4、T3的含量达到正常,要使机体组织中的T4、T3水平达到正常水平则需要增加L- T4的用量,那样又会导致促甲状腺激素(Thyroid stim ulating hormone,TSH)受抑制,引起亚临床甲亢的相关组织学表现,而使用L- T4 /T3联合治疗的方案能够使血清和大多数组织中的T4、T3水平达到正常。如果人体也相似的话,那么联合L- T4 /T3替代治疗可能是更符合生理需要的治疗方案。为此我们综述了这方面的动物实验研究和临床调查研究的进展状况。
The management of patients with primary hypothyroidism is straightforward. Recent studies suggest, however, that standard thyroid replacement therapy with thyroxine may not be completely effective in relieving the symptoms of hypothyroidism, and that there may be a role for combined use of thyroxine and triiodothyronine （T3） in the replacement therapy. Furthermore, animal studies suggest that the direct contribution by the thyroid to circulating T3 concentrations may be important, and that thyroxine alone may not be adequate treatment for hypothyroidism. In studies on thyroidectomized rats, it was found that the achievement of normal tissue concentrations of T3 required either the thyroxine at high doses which resulted in the suppression of TSH secretion, or the combined thyroxine/T3 treatment, which was able to normalize the serum thyroxine, T3 and the TSH concentrations, and the levels of thyroxine and T3 in most peripheral tissues. If the same is true of humans, there might be a more physiological replacement regimen for hypothyroid patients other than the replacement regiment of using thyroxine alone.
出处
《生物医学工程学杂志》
EI
CAS
CSCD
北大核心
2005年第2期396-399,共4页
Journal of Biomedical Engineering
