20xx年醫(yī)學(xué)專題—甲狀腺激素和抗甲狀腺藥thyroid-預(yù)覽頁
【正文】 ays, 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 release of thyroid hormone,Gastrointestinal I,Blood I,I,Peroxidase,Io,TG,Tyr,Iodation,MIT,DIT,Condensation,MIT+DIT,DIT+DIT,T3,T4,TG,Acinar lumina,Storage,Synthesis,Release,Activation,Protease,T3,T4,MIT 一碘酪氨酸 DIT 二碘酪氨酸 TG 甲狀腺球蛋白,blood,第十二頁，共三十四頁。,Thyroid clinical application,Replacement therapy mainly Therapy and diagnosis Application Cretinism Treating the infants and children as soon as possible could cure them to normal . If treating too late, they need to be treated a lifetime. Mucous edema Increase the dosage of thyroid pallet gradually . Too large dosage may aggravate heart diseases . Patients in coma should be given a fist aid, which is infusion of T3 （40120μg）intravenoiusly , reinjection 5－15μg every 6h and oral administration when awake. Hypopituitarism patients should be given cortical hormone first and followed by thyroid hormone. Simple goiter Replacement therapy can inhibit TSH oversecretion and contract the glandular organ, 36 months. T3 inhibition test Differential diagnosis for Patients with iodine high uptake.,第十六頁，共三十四頁。)） 甲亢平（又稱卡比馬唑）,第十九頁，共三十四頁。,Thiourea,Clinical application Hyperthyroidism For who has mild symptoms and is not suitable to have operations and 131I radiotherapy. Give Larger dose at the beginning. After 1~3 months, symtoms decreased and basal metabolic rate returns to almost normal . Reduce to maintaining dose with a peroid of 1~2 years. Also can be used as adjunctive therapy of 131I radiotherapy. Preparation before operation Medication before operation is good to decrease bleeding in operation and prevent thyroid crisis after operation. Adjunctive medication of thyroid crisis Besides integrate measures, large dose of Thiourea homologues can be used as adjunctive therapy, So is Propranolol.,第二十三頁，共三十四頁。 ②adjunctive therapy for thyroid crisis: could be used combined with thiourea homologues.,第二十六頁，共三十四頁。,Radioactive iodine,Adverse effects and application notes Hypothyroidism is the predominant complication. The adverse effects can be reduced by strict dose control and resisted by thyrine. Patients with Total white blood cells less than 3000/mm3 are not suitable to take it. So are pragnant and lactant women, patients younger than 20 years old or with severe liver or kidney deseases.,第三十頁，共三十四頁。,內(nèi)容(n232。Propyl 0.75 3.3 0.4
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