de Marco D, Bürgi U
Abteilung für Endokrinologie und Diabetologie, Inselspital, Bern.
Ther Umsch. 1999 Jul;56(7):400-2. doi: 10.1024/0040-5930.56.7.400.
The effectiveness of antithyroid drug treatment of Graves' hyperthyroidism is documented by measuring initially free T4 and free T3 and later free T4, free T3 and TSH. An elevated titer of the Graves'-specific thyroid stimulating antibodies is not usually rechecked before the end of the antithyroid drug therapy. Thyroxine treatment of primary hypothyroidism is controlled by TSH measurements. In patients in whom TSH levels might be affected by drugs or nonthyroid diseases, free T4 is measured in addition to TSH. The assessment of the treatment of Hashimoto's chronic thyroiditis consists of the control of the therapy of its associated hypothyroidism. In subacute thyroiditis de Quervain control of the effectiveness of the analgesic therapy is most important. To check the effect of thyroid hormone treatment given with the intent to reduce goiter size, serial sonographies are of great value. In the follow-up of patients with thyroid carcinomas, measurements of thyroglobulin (for papillary and follicular thyroid cancers) and of calcitonin (for medullary thyroid cancers) in the serum as well as thyroid scans and other imaging procedures play an important role.
通过最初测量游离T4和游离T3，随后测量游离T4、游离T3和促甲状腺激素（TSH），可证明抗甲状腺药物治疗格雷夫斯氏甲亢的有效性。在抗甲状腺药物治疗结束前，通常不会再次检查格雷夫斯氏特异性促甲状腺抗体的升高滴度。原发性甲状腺功能减退症的甲状腺素治疗通过TSH测量来控制。对于TSH水平可能受药物或非甲状腺疾病影响的患者，除了TSH外，还需测量游离T4。桥本氏慢性甲状腺炎治疗的评估包括对其相关甲状腺功能减退症治疗的控制。在亚急性甲状腺炎（德奎尔万氏甲状腺炎）中，控制镇痛治疗的效果最为重要。为检查旨在缩小甲状腺肿大小而给予的甲状腺激素治疗的效果，连续超声检查具有重要价值。在甲状腺癌患者的随访中，血清中甲状腺球蛋白（用于乳头状和滤泡状甲状腺癌）和降钙素（用于髓样甲状腺癌）的测量以及甲状腺扫描和其他成像检查起着重要作用。
