Japanese
Title正常人およびバセドウ病における下垂体 - 甲状腺系調節機構 - 高感度TSH測定法による検討 -
Subtitle《原著》
Authors高木信行*, 山内一征*, 森祐一*, 田中博志*, 三浦義孝*, 高槻健介*, 富田明夫*, 舟橋啓臣**, 水野茂**, 石突吉持***
Authors(kana)
Organization*名古屋大学医学部第一内科, **第二外科, ***石突甲状腺研究所
Journal核医学
Volume23
Number8
Page1043-1053
Year/Month1986/8
Article原著
Publisher日本核医学会
Abstract「要旨」: 正常者およびバセドウ病患者の下垂体甲状腺系調節機構を明らかにするために, immunoradiometric assay法による高感度TSH測定法を用いて検討した. 正常者では, TSHは全て測定可能であり, 遊離甲状腺ホルモン (FT) との間に負の相関関係を認めなかった. 甲状腺機能が正常な甲状腺癌患者では, 甲状腺全摘後速やかなTSHの上昇を認めた. バセドウ病では, 未治療時TSHは全て測定感度以下を示し, 治療によるFTの低下に伴うTSHの増加は1から3.5か月遅れた. 寛解期バセドウ病では, TSHの基礎値とTRHテスト時の頂値との間に良好な正相関を, FT4とは負の相関関係を認めた. バセドウ病および甲状腺癌の治療による医原性機能低下状態からの, 抗甲状腺剤の減量またはT4補充による回復過程では, TSHの正常化がFTより遅れることを認めた. 以上の結果より, 下垂体甲状腺系調節機構のset pointは個々人で異なっており, 長期間FTの過剰状態が続くと, 下垂体に何らかの可逆的な機能異常を惹起するものと推察された.
Practice臨床医学：一般
KeywordsHighly sensitive TSH assay, Immunoradiometric assay, Pituitary-thyroid axis, Normal subject, Graves' disease.
English
TitleRegulation Mechanisms of Pituitary-thyroid Axis in Normal Subjects and Patients with Graves, Disease : Using a Highly Sensitive TSH Assay
SubtitleOriginal Articles
AuthorsShinko TAKAGI*, Kazuyuki YAMAUCHI*, Yuichi MORI*, Hiroshi TANAKA*, Yoshitaka MIURA*, Kensuke TAKATSUKI*, Akio TOMITA*, Hiroomi FUNAHASHI**, Shigeru MIZUNO**, Yoshimochi ISHIZUKI***
Authors(kana)
Organization*First Department of Internal Medicine, Nagoya University School of Medicine, **Second Department of Surgery, Nagoya University School of Medicine, ***Ishizuki Thyroid Clinic
JournalThe Japanese Journal of nuclear medicine
Volume23
Number8
Page1043-1053
Year/Month1986/8
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] : The regulatory mechanism of the pituitary-thyroid axis in normal subjects and patients with Graves' disease was investigated using a highly sensitive TSH assay based on the immunoradiometric assay. All of the normal subjects had detectable TSH values within the range 0.35 to 6.0μU/ml. No negative correlations between TSH and free thyroid hormones existed in normal subjects. Patients with thyroid carcinoma who seemed to have normal pituitary-thyroid function showed a rapid increase of TSH after total thyroidectomy. On the other hand, while untreated patients with Graves' disease all had undetectable TSH values, these patients took 1 to 3.5 months longer to normalize their TSH values than to normalize free thyroid hormones on antithyroid drug therapy. During the recovery phase by the treatment with decrease of antithyroid drug or supplement of T4 from iatrogenic hypothyroid state after treatment for Graves' disease and thyroid carcinoma, normalization of TSH levels was delayed than that of free thyroid hormones. Patients with Graves' disease in remission showed an extremely positive correlation between basal and peak TSH levels in TRH test, and a negative correlation between basal TSH and FT4. In conclusion, an individual patient may have a different set point concerning the regulatory mechanism of the pituitary-thyroid axis, and the persistence of the hyperthyroid state would seem to have caused some reversible dysfunction of the pituitary gland.
PracticeClinical medicine
KeywordsHighly sensitive TSH assay, Immunoradiometric assay, Pituitary-thyroid axis, Normal subject, Graves' disease.

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