摘要
目的了解甲状腺功能亢进症 (简称甲亢 )患者肾上腺皮质功能的变化 ,为临床治疗提供理论依据。方法通过对比正常人、轻度及重度甲亢患者肾上腺皮质对小剂量促肾上腺皮质激素(ACTH)刺激的反应 ,判断其肾上腺皮质功能状态。结果 3组患者在无应激状态下肾上腺皮质功能差异无显著性 ,但对小剂量ACTH刺激的反应不同 ,对照组及轻度甲亢组反应一致 ,皮质醇增加明显 ,重度甲亢组反应显著降低 ,皮质醇增加不明显 ,经完全随机设计的单因素方差分析 ,各时点及AUC在 3组之间差异有显著性 (15、30、6 0、90min及AUCF值分别为 2 78 3、2 74 2、4 6 9 8、2 73 3、86 6 2 ,P <0 0 0 1) ,再经最小显著差异法 (LSD t检验 )进行两两比较 ,重度甲亢组与对照组及轻度甲亢组比较差异均有显著性 (P <0 0 0 1) ,而对照组及轻度甲亢组比较差异均无显著性 (P >0 0 5 )。结论重度甲亢患者肾上腺皮质应激能力显著降低 ,可能是甲状腺危象发生的病理生理基础。
Objective To explore the change of function of adrenal cortex in patients with hyperthyroidism to provide theoretical evidence for clinical practice. Methods The reaction of adrenal cortex to small dosage of ACTH was detected and compared with each other in normal controls,in patients with mild hyperthyroidism,and patients with severe hyperthyroidism. Results The reaction to small dosage of ACTH was statistically different among the three groups \[F=278.3(15 min), 274.2(30 min), 469.8 (60 min), 273.3(min),866.2(AUC),P<0.001\],LST-t test also yielded significant differences between the three groups. The reactions in severe group decreased significantly compared with that in control group and in mild hyperthyroidism group (P<0.001). Conclusions The capacity of adrenal cortex to deal with stress in patients with severe hyperthyroidism is decreased remarkably, which constitutes the pathophysiological basis of thyroid crisis.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第8期496-497,共2页
Chinese Journal of General Surgery
