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1、ThephysiologicalfunctionsofthyroidglandSynthesize,reserveandsecretethyroxine3,5,3’,5’-tetraiodothyronine,T43,5,3’-triiodothyronine,T3SynthesisofthyroidhormonesConcentratesiodineOrganification:iodineoxidationanditsincorporationintotyrosinetoformmonoiodotyr
2、osine(MIT)anddiiodotyrosine(DIT)Coupling:T4andT3arisefromthecouplingofeither2DITresiduesor1MITand1DITresidue(requiresthyroidperoxidase)CirculatingT4andT3Thyroidhormonesexistintwoforms,freeandproteinboundthefreehormoneconcentrationdeterminesthethyroidstatu
3、sirrespectiveofthetotalplasmaconcentrationthetotalhormoneisdeterminedbythyroxine-bindingglobin(TGB)andalbumin.Thethyroidcellhasabilitytoconcentrateiodine,therefore,thestationofthyroidglandcanbejudgedbycheckingiodineuptakeThyroidperoxidaseplaysanimportantr
4、oleinthecourseoforganificationandcoupling.Compoundsthatinhibitedtheactivityofthyroidperoxidasecanbeusedinthetreatmentofpatientswithhyperthyroidism.SignificanceIncreasedTBG1.Pregnancy2.Treatmentwithsupraphysiologicamountsofestrogens,雌激素類includingoralcontra
5、ceptives.口服避孕藥3.InsomepatientswithcirrhosisoracutehepatitisDecreasedTBG1.Proteinmalnutrition,hepaticfailure,chronicillness2.Nephroticsyndrome3.Duringtreatmentwithandrogenicsteroids雄激素orpharmacologic藥理學(xué)dosesofglucocorticoidsthyroxine-bindingglobin(TGB)Test
6、softhyroidfunctionMeasurementoftotalserumthyroidhormoneconcentrationsSerumfreeT4andT3concentrationsRadioactiveiodineuptake3h24hPeaknormal5%-25%20%-45%24hhypothalamuspituitaryThyroidglandTRH＋TSH＋T3T4－－SmalldoseiodoineLargedoseiodine＋－甲狀腺激素分泌的調(diào)節(jié)Serumthyrotr
7、opinTestsofthyroidregulationAnatomicevaluationofthethyroidglandThethyroidscanThyroidultrasoundNeedlebiopsyOthertestsspecificallyrelatedtothyroidfunctionordiseaseAnti-thyroidantibodiesthyroidmicrosomalantibody(TMAb)thyroglobulinantibodies(TgAb)thyroidTSHre
8、ceptor(TRAb’s)TherolesofthyroidhormonesregulatetissuemetabolismcentralnervoussystemdevelopmentgrowthandbonematurationGoiterEpithelialcellsbenignhyperplasia,noninflammationandnontumorNontoxicgoiter(simplegoiter):euth
