TRH兴奋试验对甲亢患者治疗后造成甲低的评价  

Assessment of Hypothyrodism in Treated Patients with Hyperthyroidism by Thyrotropin Releasing Hormone Stimulation Test

作　　者：李心欣 李成浩 李春田 

机构地区：[1]沈阳市空军第463医院

出　　处：《中国医师杂志》1999年第8期15-16,共2页Journal of Chinese Physician

摘　　要：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３１９１μＩＵ／ｍｌ和４９５０μＩＵ／ｍｌ，显著高于甲功正常组（其平均ＴＳＨ为６３２μＩＵ／ｍｌ），９０ｍｉｎ后ＴＳＨ明显下降，其平均值分别为１８５１μＩＵ／ｍｌ和４３９０μＩＵ／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。In order to detect hypothyroidism from treated patients with hyperthyroidism much earlier,serum thyroid hormone and TSH concentrations and their interrelations were determined before and after intravenous injection of 300μg of TRH in 44 treated patients with hyperthyroidism that included 22 euthyroid patients, 9 patients with subclinical hypothyroidism and 13 patients with clinical hypothyroidism.Thirty minutes after TRH stimulation in patients with subclinical and clinical hypothyroidism,their average value in serum TSH were 31.91μIU/ml and 49.50μIU/ml,respectively,and significantly different from that of the euthyroid patients,then 90 min after TRH test,TSH levels were decreased,and were 18.51μIU/ml and 43.90μIU/ml,respectively,but still remained at a higher lever than that of basal value (4.25μIU/ml,20.56μIU/ml,respectively).In 16 patients with subclinical and clinical hypothyroidism,serum basal levels of TT 4 and FT 4 showed an negative correlation with serum basal level of TSH,and serum basal level of FT 4 also showed an negative correlation with the average value of serum TSH after TRH test.It suggests that the TRH test may be recommended as one of the markers used for early diagnosis of subclinical hypothyroidism.

关 键 词：甲状腺机能亢进 甲状腺功能试验 甲状腺功能低下 

分 类 号：R581.105[医药卫生—内分泌] R581.2[医药卫生—内科学]