Gibbons Veronique, Lillis Steven, Conaglen John V, Lawrenson Ross
Waikato Clinical School, Waikato Hospital, Hamilton, New Zealand.
N Z Med J. 2009 Aug 21;122(1301):25-30.
The presenting features of early thyroid disease can be subtle and non-specific; consequently, general practitioners (GPs) have a low threshold for ordering thyroid function tests (TFTs). This study examined the use and results of TFTs by GPs in a 1-year period in a population-based sample of adults without known thyroid disease enrolled in general practice.
This record linkage study analysed the use of TFTs over a 12-month period from laboratory data, which were linked to patient's GP records from two large urban New Zealand general practices with a total registered population of 21,290 patients. Outcomes were analysed by age and gender.
One in six adult patients visiting their GP in a 12-month period had a thyroid stimulating hormone (TSH) test, whilst only 1 in 20 had a free thyroxine (FT4) test. 7.0% had an elevated TSH concentration and 1.0% had a low TSH concentration, most with subclinical disease. Rate of testing was higher in females compared with males.
This study suggests that general practitioners are opportunistically screening with TSH alone to find new cases of thyroid disease.
早期甲状腺疾病的表现可能较为隐匿且不具有特异性；因此，全科医生（GP）开具甲状腺功能检查（TFT）的门槛较低。本研究调查了在一年时间里，全科医生对未患甲状腺疾病的成年人群进行TFT检查的情况及结果。
这项记录关联研究分析了12个月内实验室数据中TFT检查的使用情况，这些数据与新西兰两个大型城市全科诊所的患者全科医生记录相关联，这两个诊所的注册患者总数为21,290人。结果按年龄和性别进行分析。
在12个月内就诊于全科医生的成年患者中，六分之一接受了促甲状腺激素（TSH）检查，而每二十人中只有一人接受了游离甲状腺素（FT4）检查。7.0%的患者TSH浓度升高，1.0%的患者TSH浓度降低，大多数为亚临床疾病。女性的检查率高于男性。
本研究表明，全科医生仅通过TSH进行机会性筛查以发现甲状腺疾病新病例。
