Feigl D, Tuval M, Nakash I
Dept. of Medicine D, Edith Wolfson Hospital, Holon.
Harefuah. 1992 Mar 1;122(5):294-6.
Elevated blood levels of thyroid hormones may be due to causes other than glandular hyperactivity. We have seen transient increases in total thyroxine (TT4), free thyroxine index (FTI), free thyroxine (FT4), and total triiodothyronine (TT3) in 12 women and 3 men with subacute thyroiditis and 2 women with painless (silent) postpartum thyroiditis. Elevated TT4, FTI, and FT4 were found in 11 of 85 patients treated with amiodarone. High TT4, but not FTI or FT4, was seen in 4 women using contraceptives, in 2 pregnant women and in 2 men with liver dysfunction. All hormones, except TSH, were elevated in a patient in whom thyrotoxicosis factitia was later proved. High FTI, TT4 or FT4 but not TT3 were detected in 11 of 20 patients treated with l-throxine after surgical thyroidectomy and in 10 of 68 treated for hypothyroidism. To avoid treating when thyroxicosis is not present and to avoid reducing or stopping vital drug treatment, familiarity with these states which alter blood hormone levels is important.
甲状腺激素血水平升高可能由腺体功能亢进以外的原因引起。我们在12名女性和3名男性亚急性甲状腺炎患者以及2名无痛性(寂静性)产后甲状腺炎女性患者中观察到总甲状腺素(TT4)、游离甲状腺素指数(FTI)、游离甲状腺素(FT4)和总三碘甲状腺原氨酸(TT3)的短暂升高。在85名接受胺碘酮治疗的患者中,有11名患者的TT4、FTI和FT4升高。在4名使用避孕药的女性、2名孕妇和2名肝功能不全的男性中,发现TT4升高,但FTI或FT4未升高。在一名后来被证实为人为甲状腺毒症的患者中,除促甲状腺激素(TSH)外,所有激素均升高。在20名甲状腺切除术后接受左甲状腺素治疗的患者中有11名以及68名接受甲状腺功能减退治疗的患者中有10名检测到FTI、TT4或FT4升高,但TT3未升高。为避免在不存在甲状腺毒症时进行治疗以及避免减少或停止重要的药物治疗,熟悉这些改变血液激素水平的状态很重要。