Miller Glenn D, Rogers Jared C, DeGroote Sandra L, Schmitz David
University of Illinois College of Medicine and Methodist Medical Center of Illinois, Peoria, IL, USA.
J Fam Pract. 2008 Sep;57(9):613-4.
Thyroid-stimulating hormone (TSH) level is the preferred test for initial evaluation of suspected primary hypothyroidism (strength of recommendation [SOR]: expert opinion). If TSH is abnormal, a free thyroxine (T4) level will further narrow the diagnosis. Obtain a triiodothyronine (T3) level if TSH is undetectable and free T4 is normal. When assessing the adequacy of replacement therapy in primary hypothyroidism, the TSH is the most important parameter to monitor (SOR: expert opinion). Because TSH levels can't be used to monitor central hypothyroidism, use free T4 and T3 concentrations (SOR: case series).
促甲状腺激素（TSH）水平是疑似原发性甲状腺功能减退初始评估的首选检查（推荐强度[SOR]：专家意见）。如果TSH异常，游离甲状腺素（T4）水平将进一步明确诊断。如果TSH检测不到且游离T4正常，则检测三碘甲状腺原氨酸（T3）水平。在评估原发性甲状腺功能减退替代治疗的充分性时，TSH是最重要的监测参数（SOR：专家意见）。由于TSH水平不能用于监测中枢性甲状腺功能减退，因此应使用游离T4和T3浓度（SOR：病例系列）。
