Allahabadia A, Weetman A P
Department of Endocrinology and Clinical Sciences Centre, Northern General Hospital, Sheffield, UK.
J Endocrinol Invest. 2003;26(7 Suppl):31-8.
Modern assays for TSH and for free thyroid hormones have significantly reduced the need for dynamic testing of the hypothalamo-pituitary-thyroid axis in patients with biochemical thyroid dysfunction. However, under certain conditions, such as isolated TSH deficiency, thyrotropinoma and thyroid hormone resistance, the TRH test remains an important adjunctive diagnostic tool. In recent years, the development of recombinant human TSH (rhTSH) has led to a new dynamic test of thyroglobulin (Tg) secretion as a marker of recurrent or metastatic thyroid cancer. RhTSH provides an alternative to thyroid hormone suppression treatment withdrawal in patients who cannot tolerate hypothyroidism and is the agent of choice in patients unable to mount a TSH response.
现代促甲状腺激素（TSH）和游离甲状腺激素检测方法已显著减少了对甲状腺生化功能障碍患者下丘脑-垂体-甲状腺轴进行动态检测的需求。然而，在某些情况下，如孤立性促甲状腺激素缺乏、促甲状腺素瘤和甲状腺激素抵抗，促甲状腺激素释放激素（TRH）试验仍是一项重要的辅助诊断工具。近年来，重组人促甲状腺激素（rhTSH）的研发催生了一种新的动态检测方法，即检测甲状腺球蛋白（Tg）分泌情况，以此作为复发性或转移性甲状腺癌的标志物。对于无法耐受甲状腺功能减退的患者，rhTSH为停用甲状腺激素抑制治疗提供了一种替代方法，并且是无法产生TSH反应患者的首选药物。
