摘要
为了评价甲状腺激素(TH)在细胞水平的生物效应,笔者改进了外周血单个核细胞核T_3受体(T_3R)的结合分析法,并测定了甲状腺功能正常、甲状腺功能亢进(甲亢)和甲状腺功能低下(甲减)患者(各10例),外周血单个核细胞核T_3R的最大结合客量(MBC)、解离常数(Kd)及血清游离TH浓度及其效应等指标.结果甲减组患者MBC显著高于正常组;各组核T_3R与T_3的解离常数无显著差异;血清肌酸磷酸激酶(CPK)、胆固醇含量与核T_3R占据率(q)相关显著.结论:改进后的外周血单个核细胞核T_3R测定方法稳定、重复性较好、需血量少、便于应用,尤其对遗传性核T_3R缺陷患者,具有决定性诊断价值;应用Bantle计算公式计算的q方法简便,且比游离三碘甲腺氨酸(FT_3)和核T_3R参数更能反应T_3在细胞核水平的生物效应.
To evaluate the biological effects of thyroid hormones (TH) at a tissue level, we improved nuclear T3 receptor (T3R) assay and measured MBC and equilibrium dissociation constant (Kd), the concentrations of serum free thyroid hormones and their effects of nuclear T3 R in mononuclear cells in 10 euthyroid subjects, 10 patients with hyperthyroidism and 10 patients with hypothyroidism. The results showed that the MBC in hypothyroidism was obviously higher than that in euthyroidism. In hyperthyroid and hypothyroid patients, the Kd was very similar to that in euthyroid reference subjects. Nuclear T3R occupancy was found to be linearly related to serun cholesterol and CPK. It is indicated that the improved nuclear T3R assay is good in stability, repeatability and convenience, and decisive in diagnosis of hereditary T3 R deficiency . Nuclear T3 R occupancy is a better clinical index than serum FT3, FT4 or MBC of nuclear T3R for the evaluation of the biological effects of thyroid hormones at a tissue level.
