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为了从已治甲亢患者中早期检出亚临床型甲低患者,我们观察了44例治疗后甲亢患者静注TRH前后血清TSH、TT3、TT4、FT4的变化及其相互关系。结果发现临床甲低患者的血清TT3均值仍在正常范围,而TT4、FT4均值低于正常值;亚临床及临床甲低组在静注TRH后30min,TSH平均增值(△TSH)分别为3191μIU/ml和4950μIU/ml,显著高于甲功正常组(其平均TSH为632μIU/ml),90min后TSH明显下降,其平均值分别为1851μIU/ml和4390μIU/ml,但仍显著高于本组基础值,表现为明显的超常反应[1];两组的基础TT4、FT4与TSH值均呈负相关,FT4与静注TRH后TSH增值亦呈负相关。提示:诊断临床甲低,TT4和FT4比TT3灵敏;TRH兴奋试验可为亚临床甲低的早期诊断提供可靠而有力的实验室依据。
To detect subclinical hypothyroidism early in patients with hyperthyroidism, we observed the changes of TSH, TT3, TT4 and FT4 in 44 patients with hyperthyroidism before and after intravenous administration of TRH and their correlation. The results showed that the average serum TT3 in patients with clinical hypothyroidism was still in the normal range, but the average values of TT4 and FT4 were lower than those in normal hypothyroidism patients. The mean TSH (TSH) of subclinical and clinical hypothyroidism were 31% at 30 minutes after intravenous injection of TRH. 91μIU / ml and 4950μIU / ml, which were significantly higher than those in normal thyroid function group (mean TSH was 632μIU / ml). After 90min, the TSH decreased obviously, with average values of 1851μIU / ml and 4390μIU / ml, but still significantly higher than the baseline values, showing a significant abnormal response [1]; the two groups of basic TT4, FT4 and TSH values were negatively correlated, FT4 and TRH after intravenous infusion of TSH also showed a negative correlation. Hint: The clinical diagnosis of hypothyroidism, TT4 and TT4 sensitivity than TT3; TRH stimulation test for subclinical hypothyroidism early diagnosis provides a reliable and powerful laboratory evidence.