内分泌系统精品教学（南方医学院）甲亢2016.pdfVIP

甲状腺功能亢进症 （Hyperthyroidism）
 南⽅医科⼤学珠江医院内分泌科　杨⼒　副主任医师 Department of Endocrinology Zhujiang Hospital Southern Medical University SELF INTRODUCTION ■Instructor: Yang Li ■Department of Endocrinology Zhujiang Hospital Southern Medical University ■E-mail: 403276962@ 2 Thyroid Gland • The word “Thyroid” comes from the Greek … Thyreos =Shield 盾牌 The biggest organ of endocrine. Thyroid Gland Anatomy • Located in neck, anterior to trachea （⽓管）, between cricoid cartilage （环状软⻣） and sternal notch （胸⻣切迹） • Two lobes connected by isthmus （峡部） • 12 ~ 20 grams, highly vascular, soft texture. Histology Follicle （滤泡）:the Functional Units of the Thyroid Gland. calcitonin • Cell types ：follicular cells(滤泡细胞）, lymphoid cells （淋巴细胞） and “C” cells. •Two raw material: iodine(碘） and thyroglobulin （甲状腺球蛋⽩） •The thyroid hormones: thyroxine(T4, 甲状腺素) and triiodothyronine(T3,三碘甲状腺原氨酸) Biosynthesis of thyroxine(T4) and triiodothyronine(T3) 1. Iodide trapping 碘离⼦的转运 2. Oxidation of I- and iodination of thyroglobulin (Tg) tyrosine residues 碘的氧化和甲状腺球蛋⽩的酪氨 酸残基碘化形成MIT和DIT 3. Coupling of iodothyrosine molecules within thyroglobulin (formation of T3 and T4) 碘化酪氨酸残基耦 联形成 T4 和 T3 4. Proteolysis of thyroglobulin with release of T4 and T3 into the circulation Tg⽔解T4 和T3 释放⼊⾎ 5. Deiodination of T4 to T3 and rT3 T4脱碘转化为T3 甲状腺过氧化物酶 甲状腺过氧化物酶 Thyroid Axis Regulation • TRH from hypothalamus （下丘脑）stimulates pituitary gland to produce and release TSH • TSH from anterior pitui