Department of Otorhinolaryngology, Head and Neck Surgery, Sisters of Mercy University Hospital Center, Vinogradska 29, 10000 Zagreb, Croatia.
Ann Endocrinol (Paris). 2013 Feb;74(1):27-9. doi: 10.1016/j.ando.2012.11.001. Epub 2013 Jan 18.
The objective was to examine the effectiveness of levothyroxine treatment in hypothyroid patients in achieving normal thyroid stimulating hormone (TSH), T4 and T3.
Results of the treatment of 2448 hypothyroid patients treated with LT4 for at least 12 months between 2006 and 2011 (1920 with spontaneous hypothyroidism and 528 with hypothyroidism following surgery or 131I) are presented. Serum TSH, T4 and T3 were analyzed and referred as normal, increased or decreased.
Normal TSH was found in 75 and 68% of patients respectively. In subgroups with increased TSH, 15% and 14% of patients showed borderline or only mildly increased TSH (4.1-5.5 mIU/L). T4 (94 and 86%) and T3 (93 and 90% respectively) were normal in the majority of patients from both groups. LT4 over-treatment is observed in only 4 and 6% of patients respectively.
The results are less favorable for the group with hypothyroidism following surgery or (131)I than in spontaneous hypothyroidism, but in about 90% of patients with spontaneous hypothyroidism and 82% with hypothyroidism following surgery or (131)I, the LT4 dose could remain unchanged. It is discussed whether standard LT4 replacement could render normal TSH and thyroid hormone patterns in all hypothyroid patients.
研究左甲状腺素（LT4）治疗甲状腺功能减退（甲减）患者，使其甲状腺刺激激素（TSH）、T4 和 T3 恢复正常的效果。
报告了 2006 年至 2011 年间至少接受了 12 个月 LT4 治疗的 2448 例甲减患者（1920 例为自发性甲减，528 例为甲状腺手术后或 131I 治疗后甲减）的治疗结果。分析并报告了血清 TSH、T4 和 T3 的正常、升高或降低情况。
分别有 75%和 68%的患者 TSH 正常。在 TSH 升高的亚组中，15%和 14%的患者 TSH 仅轻度升高（4.1-5.5mIU/L）或处于边缘升高状态。两组患者 T4（94%和 86%）和 T3（93%和 90%）大多正常。LT4 治疗过度仅见于 4%和 6%的患者。
与自发性甲减相比，甲状腺手术后或（131）I 治疗后的甲减患者结果较差，但在 90%的自发性甲减患者和 82%的甲状腺手术后或（131）I 治疗后的甲减患者中，LT4 剂量可保持不变。讨论了标准 LT4 替代治疗是否能使所有甲减患者的 TSH 和甲状腺激素水平恢复正常。
