Flattet A, Burger A G
Schweiz Med Wochenschr. 1986 Feb 8;116(6):169-72.
The "euthyroid sick syndrome", representing the changes of thyroid hormone metabolism in disease, embraces the following hormonal changes: 1) A decrease in serum T3 levels which is often accompanied by an increase in rT3 levels. Serum T4 levels remain normal. These changes are extremely frequent in many varied diseases. 2) In very severe disease, serum T4 levels may also decrease. The free T4 index is often decreased and the free T4 may either be normal or decreased. These changes reflect alterations of thyroid hormone metabolism and can be distinguished from primary hypothyroidism by a normal serum TSH level. 3) Occasionally there are transient increases of total and free T4. This disturbance of serum thyroid hormone levels is mostly due to drug interference with thyroid hormone metabolism (amiodarone etc.). Differentiation from hyperthyroidism is difficult. It is important to diagnose the "euthyroid sick syndrome" since this will avoid erroneous diagnosis and treatment or hypo- and hyperthyroidism.
“甲状腺功能正常的病态综合征”表现为疾病状态下甲状腺激素代谢的变化，包括以下激素变化：1）血清T3水平降低，常伴有反T3（rT3）水平升高。血清T4水平保持正常。这些变化在多种疾病中极为常见。2）在非常严重的疾病中，血清T4水平也可能降低。游离T4指数常降低，游离T4可能正常或降低。这些变化反映了甲状腺激素代谢的改变，可通过血清促甲状腺激素（TSH）水平正常与原发性甲状腺功能减退相鉴别。3）偶尔会出现总T4和游离T4的短暂升高。血清甲状腺激素水平的这种紊乱主要是由于药物干扰甲状腺激素代谢（如胺碘酮等）。与甲状腺功能亢进症鉴别困难。诊断“甲状腺功能正常的病态综合征”很重要，因为这将避免对甲状腺功能减退症和甲状腺功能亢进症的错误诊断和治疗。
