20xx年醫(yī)學(xué)專題—甲狀腺激素和抗甲狀腺藥thyroid(已修改)
2024-11-12 05:21 本頁面
【正文】 甲狀腺激素(jī s249。)和抗甲狀腺藥Thyroid hormones and antithyroid drugs,北京(běi jīnɡ)協(xié)和醫(yī)學(xué)院基礎(chǔ)醫(yī)學(xué)院藥理學(xué)系 葉菜英,第一頁，共三十四頁。,Summary Thyroid hormones Necessary to maintain normal metabolism, growth and development. Hypothyroidism Cause Cretinism if it happens in embryo or neonatal period. Cause myxedema if it happens in adults when the thyroid hormone could be used in replacement therapy. Hyperthyroidism A syndrom characterized by thyroid oversecretion and metabolic disorder caused by multiple reasons. It can be treated with radioactive iodine (131I) irradation, antithyroid drugs and operation.,第二頁，共三十四頁。,Thyroid hormones,Thyroxine, T4 Triiodothyreninum natricum, T3 Synthesized and secreted by thyroid,第三頁，共三十四頁。,抗甲狀腺藥,分為4類： 硫脲類 Thiourea 碘和碘化物 （復(fù)方碘溶液， lugol’s solution） ） 放射性碘（131I） β受體阻斷(zǔ du224。n)藥（心得安等從略）,第四頁，共三十四頁。,硫脲類,硫氧嘧啶類（thiouracil）： 甲基硫氧嘧啶（methykthiouracil） 丙基硫氧嘧啶（propylthiouracil） 咪唑類（imidazoles） 他巴唑（Tapazole，甲巰咪唑(mī zu242。)methimazole） 甲亢平（卡比馬唑Carbimazole）,第五頁，共三十四頁。,Thyroid hormones are iodic amino acids Active components Thyroxine, T4 Triiodothyreninum natricum, T3 Chemical constitution,Thyroid hormones,第六頁，共三十四頁。,甲狀腺激素(jī s249。)的化學(xué)結(jié)構(gòu),第七頁，共三十四頁。,Physiological disposition of thyroid hormones,Absorbed rapidly when take orally , activity T3T4，maintaining time T4T3. T1/2 of T4 and T3 are 6－7 days and 1－2 days, respectively. Deiodination in mitochondria of liver and kidney, eliminated by kidney affer conjugated with glucuronic acid and sulfuric acid. T3, T4 can also pass the placenta and enter milk. Figure: the amount of normal adults’ thyroid hormones produced and metabolized daily.,第八頁，共三十四頁。,Synthesis, storage and regulation of thyroid hormones,Iodine uptake Iodine activation and tyrosine iodation Condensation and storage Disintegration and release Regulation,第九頁，共三十四頁。,Steps of thyroid hormones synthesis, release and regulation (Ⅰ),Iodine uptake: I－ in blood can be uptaken into cells by iodine pump in the adenocyte membrane . The amino acids can be used to synthesize thyroid globulin in cells. Iodine activation and tyrosine iodation: I－ uptaken into cells can be oxydized to active iodine by peroxydase. Active iodine binds to tyrosine of TG and forms monoiodotyrosine (MIT) and diiodotyrosine (DTT).,第十頁，共三十四頁。,Condensation and storage: In the thyroid globulin molecule , two DTTs are condensed to T4 , one DTT and one MIT are condensed to T3，which are all stored in gland alveolus colloid . Disintegration and release: T3 and T4 are released into blood after hydrolyzed by proteases .At the same time , some of them can be turned back to tyrosine and I－ by deiodinase in cells and reused. Regulation: By the
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