Wilansky D L, Greisman B
Department of Medicine, Etobicoke General Hospital, Rexdale, Ontario, Canada.
Am J Obstet Gynecol. 1989 Mar;160(3):673-7. doi: 10.1016/s0002-9378(89)80056-0.
The functional status of the thyroid gland was evaluated in 67 apparently euthyroid menorrhagic women by a thyrotropin-releasing hormone test. Fifteen of 67 showed mild primary hypothyroidism characterized by a small but significant elevation of basal levels of thyroid-stimulating hormone (5.9 +/- 0.76 versus 2.4 +/- 0.24 mU/L) and lowering of serum thyroxine levels (85 +/- 4.2 versus 105 +/- 3.0 nmol/L) to levels that were nevertheless within the normal range and exaggerated response of serum thyroid-stimulating hormone and thyroxine to administration of thyrotropin-releasing hormone. Triiodothyronine levels showed no significant change. The terms early and potential hypothyroidism appear to better describe the preliminary phases of hypothyroidism than do other terms in current use. Menorrhagia disappeared within 3 to 6 months and did not reappear in 1 to 3 years of follow up in all patients with early hypothyroidism to whom L-thyroxine was given. This was accompanied by a significant decline in random serum thyroid-stimulating hormone levels and rise of thyroxine levels to those found in the group with a negative response to the thyrotropin-releasing hormone test, with no change in levels of triiodothyronine. Further systematic study of thyroid function in menorrhagia is warranted.
通过促甲状腺激素释放激素试验，对67名甲状腺功能正常但月经过多的女性的甲状腺功能状态进行了评估。67名女性中有15名表现为轻度原发性甲状腺功能减退，其特征为促甲状腺激素基础水平小幅但显著升高（5.9±0.76对2.4±0.24 mU/L），血清甲状腺素水平降低（85±4.2对105±3.0 nmol/L），不过仍在正常范围内，且血清促甲状腺激素和甲状腺素对促甲状腺激素释放激素给药的反应增强。三碘甲状腺原氨酸水平无显著变化。“早期和潜在甲状腺功能减退”这一术语似乎比目前使用的其他术语更能描述甲状腺功能减退的初始阶段。在所有接受左甲状腺素治疗的早期甲状腺功能减退患者中，月经过多在3至6个月内消失，在1至3年的随访中未再次出现。这伴随着随机血清促甲状腺激素水平显著下降，甲状腺素水平升至对促甲状腺激素释放激素试验无反应组的水平，三碘甲状腺原氨酸水平无变化。有必要对月经过多患者的甲状腺功能进行进一步的系统研究。
