Kawabe T, Komiya I, Endo T, Koizumi Y, Yamada T
J Am Geriatr Soc. 1979 Apr;27(4):152-5. doi: 10.1111/j.1532-5415.1979.tb06438.x.
In 65 elderly hyperthyroid patients (age range 50-78 years), sex differences, signs and symptoms and thyroid function were studied and the data were compared with those on 48 young hyperthyroid patients (age range 20-29 years). The incidence of hyperthyroidism was 3.5 times higher in females than in males among the young patients, whereas it was approximately equal in males and females among the elderly patients. Signs and symptoms conformed with the textbook description in the young subjects but not in the elderly ones. Measurements of serum triiodothyronine (T3) and thyroxine (T4) proved useful in preventing false diagnoses in elderly patients with atypical symptoms. In some elderly subjects with marginal increases of serum T3 and T4 concentrations, measurement of serum thyroid-stimulating hormone (TSH) after administration of thyrotropin-releasing hormone (TRH) was required to achieve an accurate diagnosis. Serum T3 and T4 levels and the thyroidal uptake of radioiodine were slightly but not significantly lower in the elderly than in the young patients. A high titer of circulating thyroid auto-antibody in the elderly may be related to this slight decrease in thyroid function. Serum T3 levels were significantly lower in the elderly than in the young subjects; this suggests impairment of peripheral monodeiodination of T4. Any abnormal serum levels of T4, T3, and TSH before and after administration of TRH could easily be restored to normal by treatment with antithyroid drugs in the elderly patients.
对65例老年甲亢患者（年龄范围50 - 78岁）的性别差异、体征和症状以及甲状腺功能进行了研究，并将数据与48例年轻甲亢患者（年龄范围20 - 29岁）的数据进行了比较。在年轻患者中，女性甲亢的发病率是男性的3.5倍，而在老年患者中，男性和女性的发病率大致相等。年轻受试者的体征和症状与教科书描述相符，而老年受试者则不然。血清三碘甲状腺原氨酸（T3）和甲状腺素（T4）的测量有助于防止对有非典型症状的老年患者进行误诊。在一些血清T3和T4浓度略有升高的老年受试者中，需要在给予促甲状腺激素释放激素（TRH）后测量血清促甲状腺激素（TSH）才能做出准确诊断。老年患者的血清T3和T4水平以及甲状腺对放射性碘的摄取略低于年轻患者，但差异无统计学意义。老年患者循环甲状腺自身抗体的高滴度可能与甲状腺功能的轻微下降有关。老年受试者的血清T3水平显著低于年轻受试者；这表明T4外周单脱碘功能受损。老年患者在给予TRH前后，T4、T3和TSH的任何异常血清水平都可以通过抗甲状腺药物治疗轻松恢复正常。
