Corns C M, Miller A L
J Clin Pathol. 1986 Mar;39(3):293-6. doi: 10.1136/jcp.39.3.293.
A strategy for testing thyroid function with discretionary assay of thyroid stimulating hormone (TSH) following initial measurement of total plasma thyroxine (tT4) was retrospectively evaluated in relation to the diagnosis of primary hypothyroidism. Over a two year period 14 641 tT4 assays were done and 6887 TSH assays, of which 29% were initiated in the laboratory. The percentage of raised TSH values (over 5 mU/1) was similar to those for clinician and pathologist initiated requests (23.2% and 23.6%). Some TSH requests (1620) were cancelled; when 212 of these were subsequently analysed the TSH value was raised in 5.7% The incidence of raised TSH values in 188 patients with a tT4 below 100 nmol/1 (7.8 micrograms/100 ml), in whom TSH was not requested, was 5.3% Most of these raised TSH results could be readily explained by information available to the requesting clinician but not given on the request form.
一项针对原发性甲状腺功能减退症诊断的策略进行了回顾性评估，该策略是在首次测定总血浆甲状腺素（tT4）后酌情检测促甲状腺激素（TSH）。在两年期间，共进行了14641次tT4检测和6887次TSH检测，其中29%的TSH检测是在实验室发起的。TSH值升高（超过5 mU/1）的百分比与临床医生和病理学家发起的检测请求相似（分别为23.2%和23.6%）。一些TSH检测请求（1620次）被取消；当随后对其中212次进行分析时，TSH值升高的比例为5.7%。在188名tT4低于100 nmol/1（7.8微克/100 ml）且未被要求检测TSH的患者中，TSH值升高的发生率为5.3%。这些升高的TSH结果大多可以通过请求检测的临床医生掌握但未填写在检测申请表上的信息轻松解释。
