甲状腺激素替代治疗低T3综合征的研究进展  

Research progress in thyroid hormone replacement therapy for low T3 syndrome

作　　者：李娟 齐晶晶 吴荣 Li Juan;Qi Jingjing;Wu Rong(Department 1 of Geriatrics,General Hospital of Central Theater Command,Wuhan 430070,China)

机构地区：[1]中部战区总医院干部病房一科,武汉430070

出　　处：《中国综合临床》2022年第6期504-508,共5页Clinical Medicine of China

摘　　要：低T3综合征(low triiodothyronine syndrome,LT3S)是急危重症患者在一定疾病状态下出现的甲状腺激素水平的异常改变,临床上患者无甲状腺功能改变的相应症状。LT3S与患者病情严重程度及预后有明确的相关性,三碘甲腺原氨酸(triiodothyronine,T3)越低,提示患者病情越重,与急性生理慢性健康评分等指标联合,可预测患者病情预后。LT3S的发生发展机制较为复杂,早期可能是机体对应激状况做出的适应性改变,随病程加重和延长,可能会参与疾病进展。甲状腺激素(thyroid hormone,TH)补充治疗LT3S的临床研究很多,尤其在心脏疾病和肾脏疾病方面,但总体来说,尚无有说服力的数据来支持对LT3S患者予以TH补充治疗。目前的指南多不建议对LT3S患者进行激素替代治疗。应有新的较为统一的观察指标,以充分验证TH治疗的有效性。Low triiodothyronine syndrome(LT3S)is an abnormal alteration of thyroid hormone levels in patients with acute and severe illnesses in certain disease states,without clinical symptoms corresponding to altered thyroid function.There is a clear correlation between LT3S and the severity of the patient's condition and prognosis.The lower the triiodothyronine(T3)level is,the more severe the patient's condition is,and combined with acute physiology and chronic health score and other indicators,it can predict the prognosis of the patient's condition.The mechanism of occurrence and development of LT3S is relatively complex.In the early stage,it may be the adaptive change of the body to the stress condition.With the aggravation and extension of the disease course,it may participate in the disease progression.Current guidelines mostly do not recommend hormone replacement therapy(HRT)for patients with LT3S.New and more unified observational indicators should be available to fully verify the effectiveness of TH therapy.

关 键 词：低T3综合征 甲状腺激素 激素替代治疗 

分 类 号：R581[医药卫生—内分泌]