Hamilton W, Hutchison J H
Arch Dis Child. 1975 Jul;50(7):567-9. doi: 10.1136/adc.50.7.567.
It is desirable to detect early hypothyroidism of the mildest degree even before conventional tests of thyroid function become abnormal. Serum TSH levels (normal: undetectable to 4 muU/ml) rise in patients with mild hypothyroidism long before serum T4 and T3 levels fall. In the patient described the serum TSH level was 310 muU/ml, while other tests of thyroid function gave normal results. After treatment with thyroxine, serum TSH returned to normal. It should now be accepted that patients with mild hypothyroidism have a raised serum TSH and that thyroid insufficiency can be confidently excluded if the serum TSH concentration is normal. It is thus important to assay serum TSH when suspicion of hypothyroidism is aroused.
即使在传统的甲状腺功能检查出现异常之前,尽早检测出最轻微程度的甲状腺功能减退也是很有必要的。在轻度甲状腺功能减退患者中,血清促甲状腺激素(TSH)水平(正常:不可检测至4 mU/ml)在血清T4和T3水平下降之前很久就会升高。在所描述的患者中,血清TSH水平为310 mU/ml,而其他甲状腺功能检查结果正常。用甲状腺素治疗后,血清TSH恢复正常。现在应该认识到,轻度甲状腺功能减退患者的血清TSH升高,并且如果血清TSH浓度正常,则可以放心排除甲状腺功能不全。因此,当怀疑有甲状腺功能减退时,检测血清TSH很重要。