甲状腺肿英文.pptxVIP

甲状腺肿英文第1页/共14页 The physiological functions of thyroid gland Synthesize, reserve and secrete thyroxine 第2页/共14页 Synthesis of thyroid hormonesConcentrates iodine Organification : iodine oxidation and its incorporation into tyrosine to form monoiodotyrosine (MIT) and diiodotyrosine (DIT)Coupling: T4 and T3 arise from the coupling of either 2 DIT residues or 1 MIT and 1 DIT residue (requires thyroid peroxidase) 第3页/共14页 Circulating T4 and T3 Thyroid hormones exist in two forms, free and protein bound the free hormone concentration determines the thyroid status irrespective of the total plasma concentrationthe total hormone is determined by thyroxine-binding globin (TGB) and albumin. 第4页/共14页 The thyroid cell has ability to concentrate iodine, therefore, the station of thyroid gland can be judged by checking iodine uptake Thyroid peroxidase plays an important role in the course of organification and coupling. Compounds that inhibited the activity of thyroid peroxidase can be used in the treatment of patients with hyperthyroidism.Significance第5页/共14页 Increased TBG1.???Pregnancy2. Treatment with supraphysiologic amounts of estrogens,雌激素类including oral contraceptives.口服避孕药3.????In some patients with cirrhosis or acute hepatitis?Decreased TBG1. Protein malnutrition, hepatic failure, chronic illness2. Nephrotic syndrome3. During treatment with androgenic steroids 雄激素or pharmacologic药理学doses of glucocorticoidsthyroxine-binding globin (TGB)第6页/共14页 Tests of thyroid function Measurement of total serum thyroid hormone concentrations Serum free T4 and T3 concentrations Radioactive iodine uptake3h24hPeaknormal5%-25%20%-45%24h第7页/共14页 hypothalamuspituitaryThyroid glandTRH＋TSH ＋T3 T4－－Small dose iodoineLarge dose iodine＋－甲状腺激素分泌的调节第8页/共14页 Serum thyrotropin Tests of thyroid regulationAnatomic evaluation of the thyroid glandThe thyroid scan Thyroid ultrasound Needle biopsy Other tests specifically related to thyroid function or diseaseAnti-