Fexa J, Nĕmec J
Wýzkumný ústav endokrinologický, Praha.
Cas Lek Cesk. 1990 Jan 26;129(4):109-12.
The introduction of accurate methods for assessment of the volume of the thyroid gland in vivo into clinical practice is a new aspect of the problem of the normal size of the thyroid in healthy subjects. So far we have only vague ideas on its value in the Czechoslovak population. Standards from abroad cannot be adopted mechanically and a local investigation is necessary which will evaluate also the possible persistence of regional differences. The influence of body weight on the volume of the thyroid is accepted in general and this explains also sexual differences. There are no unequivocal views on the effect of age and the stage of the menstrual cycle on the volume of the thyroid gland; few reports on the influence of the season; there is no definite proof of the effect of smoking and alcohol consumption. Precise sonographic measurements did not prove a correlation between the volume of the thyroid gland and basic laboratory parameters (plasma thyroxine, triiodothyronine, thyroglobulin level, level of free fractions of thyroxine and triiodothyronine, globulin binding thyroxine and adenopituitary thyrotropic hormone). So far we do not know when and to what extent omission of these factors distorts diagnostic and therapeutic conclusions.
将准确的甲状腺活体体积评估方法引入临床实践，是健康受试者甲状腺正常大小问题的一个新方面。到目前为止，我们对其在捷克斯洛伐克人群中的价值只有模糊的概念。国外的标准不能机械采用，有必要进行本地调查，该调查还将评估区域差异可能存在的情况。体重对甲状腺体积的影响已得到普遍认可，这也解释了性别差异。关于年龄和月经周期阶段对甲状腺体积的影响，尚无明确观点；关于季节影响的报道很少；没有确凿证据证明吸烟和饮酒的影响。精确的超声测量并未证实甲状腺体积与基本实验室参数（血浆甲状腺素、三碘甲状腺原氨酸、甲状腺球蛋白水平、甲状腺素和三碘甲状腺原氨酸游离部分水平、球蛋白结合甲状腺素和腺垂体促甲状腺激素）之间存在相关性。到目前为止，我们不知道何时以及这些因素在多大程度上会扭曲诊断和治疗结论。
