原发性甲状腺功能减退症中甲状腺素治疗的重新评估。
Reappraisal of thyroxine treatment in primary hypothyroidism.
作者信息
Hodges S, O'Malley B P, Northover B N, Woods K L, Swift P G
机构信息
Department of Child Health, University of Leicester.
出版信息
Arch Dis Child. 1990 Oct;65(10):1129-32. doi: 10.1136/adc.65.10.1129.
The optimum daily dose of thyroxine was calculated for 13 children aged 3-16 years with primary hypothyroidism by titrating their doses at monthly intervals. The condition of the thyroid was assessed by sensitive assay of thyroid stimulating hormone concentrations, as well as measurement of total and free thyroid hormone concentrations and systolic time interval ratios. Serum thyroid stimulating hormone concentration was found to be the most responsive to small changes in thyroxine. The calculated optimum daily replacement dose of thyroxine (102 micrograms/m2 or 3.5 micrograms/kg) was fractionally lower than that previously recommended, and was more closely related to surface area (coefficient of variation 8.2%) than to body weight (coefficient of variation 16.2%). Our results suggest that though monthly may be the optimal time interval for increases in the dose of thyroxine, any reduction in the dose should be made more gradually.
通过每月调整剂量，计算出13名3至16岁原发性甲状腺功能减退儿童的甲状腺素最佳日剂量。通过敏感检测促甲状腺激素浓度以及测量总甲状腺激素和游离甲状腺激素浓度及收缩期时间间期比值来评估甲状腺状况。发现血清促甲状腺激素浓度对甲状腺素的微小变化最敏感。计算出的甲状腺素最佳日替代剂量（102微克/平方米或3.5微克/千克）略低于先前推荐的剂量，并且与体表面积（变异系数8.2%）的相关性比与体重（变异系数16.2%）的相关性更强。我们的结果表明，虽然每月可能是增加甲状腺素剂量的最佳时间间隔，但任何剂量的减少都应更缓慢地进行。
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