Varl B, Pavlin K
University Clinic for Nuclear Medicine, Ljubljana, Yoguslavia.
Acta Med Austriaca. 1990;17 Suppl 1:71-3.
Serum TSH, T4 and T3 have been assayed in three groups of older persons (greater than 60 years): in 28 normal subjects (A), in 80 patients with nontoxic goitre (B), in 22 patients with hyperthyroidism (C). Group B was divided in group B-1 (TSH 0.20-0.30 mU/l) and group B-2 (TSH greater than 0.30 mU/l). The test characteristics were determined by comparison of group C patients with group A patients and the former with group B patients. The specificity and posterior probability of TSH test calculated by the first comparison was 1.0 for both characteristics, and by the second comparison TSH test specificity was 0.75 and posterior probability 0.62. Specificity of thyroid hormones calculated in the second comparison was 0.96 for T4-test and 0.94 for T3-test. Therefore TSH test is the most adequate in clinical diagnostic of thyrotoxic goiter. The particularities of several groups were: B-2 group had significantly lower mean value of T4 than Group A, but there was no significant difference between mean values of TSH found. There were no correlations between TSH and T4 and between T4 and T3. Group B-1 had significantly lower mean TSH value than Group A and Group B, but the groups did not differ in mean T4 value. The correlation between TSH and T4 in group was positive as the correlation between T4 and T3. It is suggested that the value of serum T4 of Group B-1 may be inappropriately low due to defective immunological activity of T4 from autonomous follicles.(ABSTRACT TRUNCATED AT 250 WORDS)
对三组老年人(年龄大于60岁)进行了血清促甲状腺激素(TSH)、甲状腺素(T4)和三碘甲状腺原氨酸(T3)检测:28名正常受试者(A组)、80名非毒性甲状腺肿患者(B组)、22名甲状腺功能亢进患者(C组)。B组又分为B - 1组(TSH为0.20 - 0.30 mU/l)和B - 2组(TSH大于0.30 mU/l)。通过将C组患者与A组患者以及C组患者与B组患者进行比较来确定检测特征。第一次比较计算得出的TSH检测特异性和后验概率这两个特征均为1.0,第二次比较TSH检测特异性为0.75,后验概率为0.62。第二次比较计算得出的甲状腺激素特异性,T4检测为0.96,T3检测为0.94。因此,TSH检测在甲状腺毒性甲状腺肿的临床诊断中最为适用。几组的特点如下:B - 2组T4的平均值显著低于A组,但TSH平均值之间无显著差异。TSH与T4之间以及T4与T3之间均无相关性。B - 1组TSH的平均值显著低于A组和B组,但两组T4平均值无差异。该组中TSH与T4之间的相关性以及T4与T3之间的相关性均为正相关。提示B - 1组血清T4值可能因自主滤泡中T4免疫活性缺陷而偏低。(摘要截选至250词)