甲状腺癌术后TSH抑制治疗机理学习

1、甲状腺癌术后TSH抑制治疗机理学习中山市人民医院普外二科黄辉甲状腺(thyroid gland)Thyroid carllkrqvTKyrai d glBra4Tr-oroThyroid是脊椎动物 非常重要的腺体，属 于内分泌器官。在它位于颈部甲状软骨下方，气管两旁。人类的甲状腺形 似蝴蝶.甲状腺(thyroid gland)r滤泡上皮细胞士'滤泡旁细胞壁follicle胶质甲状腺球蛋白滤泡间结缔组织:含丰富的有孔毛细血管Hyoid boneThyroid cartilageEpiglottisInternal carotid arteryCommon carotid arteryIn

2、ferior thyroid arteryT-r- External carotid，arterySuperior thyroidJ arteryIsthmus of thyroid glandV 一. M_，一 一Trachea -日 rachiocephalic arteryAortaLed subclavian artery Left lateral lobe of thyroid glandColloid-filledfollicles Follicle cells(b) Section of thyroid glandFollicular cells secrete thyroid

3、hormone.Brief descriptions甲状腺腺泡上皮细胞分泌与释放 主要成分Thyroid hormone与含碘的甲状腺球蛋白thyroglobulin, TG细胞外（腺泡腔内）储存储存量大50-120d甲状腺激素的生物合成、分泌与调节 1碘的摄取一甲状腺功能指标之一 2碘的活化与雒氨酸碘化 3耦联 4释放 5调节甲状腺素和它的前体细胞:BloodoColloidTPOTPDProteinSecondarysynthesis丁3 T4EnzymesEnzymes.ThyroglobulinThyrogtobulm 4 Lt3 t4t4，丁i/rsjd iJDnuojjFollic

4、ular cell synthesizes enzymes and thyroglobulin for colloid. Y is co-transported into the cell withNa* and transported into colloid.)Enzymes add iodine toihyroglobulin J to make T3 and T4.Thyroglobulin is taken back into the cell. Intracellular enzymes separate T? and T4. from the protein*Free T3 an

5、d T4 enter the circulatiicin.Thyroxine and its precursors:Structure & Synthesis(2 tyrosine + 41)(2 tyrosine + 31)yroiormoneciReguI at i on of ThCopjTiht© Pearson Education. Ire. pcNshhg as Bsijamn Cummings.药代动力学T4血浆蛋白(主要为甲状腺结合球蛋白TBG)结合率高，99%以上。2 T3作用快而强，但T1/2短(1 -2d), T4作用弱而慢, 但作用时间长(T1/2, 6-7d)3 T4可在肝、肾、心、肌肉中在 作用下转变成T34 T3/T4可通过胎盘屏障，可经乳汁分泌药理作用维持生长发育促进蛋白质的合成及