Walmsley R N, Penhaligon J
Med J Aust. 1976 Nov 27;2(22):821-3. doi: 10.5694/j.1326-5377.1976.tb115395.x.
The results of in-vitro thyroid function tests and clinical details of 1,517 patients are reviewed, and the total serum thyroxine levels and the free thyroxine indices are compared in terms of their diagnostic value. Only 3-7% of the patients investigated had a total serum thyroxine level (T4) that did not correlate with the free thyroxine index. We believe that the evidence is strong enough to suggest that estimation of the T4 is an adequate screening test for thyrometabolic disease, and that performing the extra test (T3 resin uptake) in order to estimate the free thyroxine index (FTI) cannot be justified in terms of cost-benefit. We suggest that the FTI is indicated only in those cases in which the T4 is outside the 80% limit range. A simple scheme for the investigation of thyrometabolic disorders is presented.
回顾了1517例患者的体外甲状腺功能测试结果及临床细节，并比较了总血清甲状腺素水平和游离甲状腺素指数的诊断价值。在接受调查的患者中，只有3%至7%的患者总血清甲状腺素水平（T4）与游离甲状腺素指数不相关。我们认为，有足够的证据表明，T4的测定是甲状腺代谢疾病的一种充分的筛查试验，从成本效益的角度来看，进行额外的试验（T3树脂摄取）以估计游离甲状腺素指数（FTI）是不合理的。我们建议，仅在T4超出80%限值范围的情况下才需要测定FTI。本文还提出了一种甲状腺代谢紊乱的简单检查方案。
