Deam D, Goodwin M, Ratnaike S
Biochemistry Department, Royal Melbourne Hospital, Victoria, Australia.
Clin Chem. 1991 Apr;37(4):569-72.
We performed a limited evaluation of four free thyroxin (FT4) reagent kits: the Amerlex-M (AFT4), the Amerlite (LFT4), the MagicLite (MFT4), and the GammaCoat two-step RIA (GFT4). FT4 was measured in specimens from 201 subjects: 19 healthy controls, 14 patients who were thyrotoxic, 13 who were hypothyroid, 59 who had a past history of thyroid disease, seven with thyroxin autoantibodies, seven who were taking amiodarone, and 82 who had no clinical indication of thyroid hormone abnormality. Of these 201 subjects, 78 had a low serum albumin (less than 35 g/L) and 27 had severe nonthyroidal illness. We also investigated 60 pregnant subjects. We found no correlation between thyroxin-binding globulin (TBG) and FT4 in any of the assays, and only the AFT4 method showed a significant correlation with albumin concentrations. The presence of autoantibodies to thyroxin affected the results of all methods except the GFT4 method. All methods showed a decrease in mean FT4 values in late pregnancy. Correlation of patients' clinical state and FT4 results suggested that the reference ranges published by the manufacturers need to be modified for our laboratory.
我们对四种游离甲状腺素（FT4）试剂试剂盒进行了有限评估：Amerlex-M（AFT4）、Amerlite（LFT4）、MagicLite（MFT4）和GammaCoat两步放射免疫分析（GFT4）。对201名受试者的样本进行了FT4测量：19名健康对照者、14名甲状腺毒症患者、13名甲状腺功能减退患者、59名有甲状腺疾病既往史者、7名有甲状腺素自身抗体者、7名正在服用胺碘酮者以及82名无甲状腺激素异常临床指征者。在这201名受试者中，78人血清白蛋白水平较低（低于35 g/L），27人患有严重的非甲状腺疾病。我们还调查了60名孕妇。我们发现在任何检测中，甲状腺素结合球蛋白（TBG）与FT4之间均无相关性，只有AFT4方法显示与白蛋白浓度存在显著相关性。甲状腺素自身抗体的存在影响了除GFT4方法外所有方法的检测结果。所有方法均显示妊娠晚期平均FT4值下降。患者临床状态与FT4结果的相关性表明，制造商公布的参考范围需要针对我们实验室进行修改。
