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以前对慢性肾功能衰竭(CRF)病人中是否存在下丘脑-垂体-甲状腺轴功能紊乱的意见不一。作者对25名临床上甲状腺正常的 CRF 病人的下丘脑-垂体-甲状腺轴进行研究。这些病人中有8例保守治疗,9例作腹膜透析,8例作血透析。发现所有病人血清总甲状腺素(T_4)及总三碘甲状腺氨酸(T_3)浓度均明显减低。但游离 T_4正常而肾功能衰竭最严重的病人其游离 T_3减低。促甲状腺素(TSH)对促甲状腺素释放激素(TRH)反应大多呈延迟反应,且有部分病人反应减低或缺如。
There were conflicting opinions on whether there was hypothalamic-pituitary-thyroid axis dysfunction in patients with chronic renal failure (CRF). The authors studied the hypothalamic-pituitary-thyroid axis in 25 clinically normal thyroid patients with CRF. Eight of these patients were treated conservatively, 9 were peritoneal dialysis and 8 were hemodialysis. All patients were found to have significantly lower total thyroxine (T_4) and total triiodothyronine (T_3) concentrations. But the free T_4 normal and the most serious renal failure in patients with its free T_3 decreased. Thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) mostly delayed response, and some patients with reduced response or lack of response.