Schlienger J L, Sapin R, Gasser F, Chabrier G, Simon C, Imler M
Presse Med. 1987;16(1):15-8.
The characteristics of an ultrasensitive thyrotropin (TSH) assay method using monoclonal antibodies (TSH-U) were determined in euthyroid subjects, either healthy or with extra-thyroid disease, in treated and untreated hyper-and hypothyroid subjects and in subjects under amiodarone. The thyroid function was evaluated by free thyroxine (FT4) and free triiodothyronine (FT3) assays and by TSH tests and TSH response to TRH. With a sensitivity of 1 and a specificity of 0.94, the TSH-U assay proved highly reliable to evaluate the thyroid function. Dysthyroidism can be excluded when TSH-U levels are normal (0.15 to 4.5 microU/ml). In case of low TSH-U level, measurements of FT4 and FT3 and, if required, thyroid gland scintigraphy are necessary to confirm a diagnosis of hyperthyroidism. In contrast, a high TSH-U level is sufficient for affirm diagnosis of hypothyroidism. The TSH-U assay makes the TRH test redundant and can differentiate between hyperthyroxinaemia with euthyroidism and with hyperthyroidism. It is an effective method to detect disorders in thyroid function and it calls for a re-evaluation of thyroid diagnostic strategy.
在甲状腺功能正常的受试者（包括健康者及患有甲状腺外疾病者）、经治疗和未经治疗的甲状腺功能亢进及减退受试者以及服用胺碘酮的受试者中，测定了一种使用单克隆抗体的超敏促甲状腺激素（TSH）检测方法（TSH-U）的特性。通过游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）检测、TSH检测以及TSH对促甲状腺激素释放激素（TRH）的反应来评估甲状腺功能。TSH-U检测的灵敏度为1，特异性为0.94，被证明在评估甲状腺功能方面高度可靠。当TSH-U水平正常（0.15至4.5微国际单位/毫升）时，可以排除甲状腺功能障碍。若TSH-U水平较低，需检测FT4和FT3，必要时进行甲状腺闪烁扫描以确诊甲状腺功能亢进。相反，TSH-U水平升高足以确诊甲状腺功能减退。TSH-U检测使TRH检测变得多余，并且能够区分甲状腺功能正常伴甲状腺素血症与甲状腺功能亢进伴甲状腺素血症。它是检测甲状腺功能紊乱的有效方法，需要对甲状腺诊断策略进行重新评估。
