Karetnikov Iu P
Probl Endokrinol (Mosk). 1986 May-Jun;32(3):14-7.
The paper is concerned with a comparative analysis of the clinical signs of hypothyrosis, thyroid and calcium regulating functions. A decreased or increased reaction of TTH to TRH was revealed; it was accompanied by disorder of calcium regulating function determined by the level of calcitonin, parathyrin and ionized calcium, all these indices being evaluated by a mathematical table proposed by K. I. Myshkin with relation to a severity of the signs of hypothyrosis. An elevated level of calcitonin in the blood was observed in primary hypothyrosis with an increased reaction of TTH to TRH. A percentage ratio of calcitonin to parathyrin grew with an increased level of ionized calcium. Clinical signs of hypothyrosis either decreased or disappeared completely, clinical signs of hypoparathyrosis (relative hypoparathyrosis) appeared making the diagnosis of hypothyrosis difficult. There was a decrease in the calcitonin content in primary hypothyrosis with insufficient reaction of TTH to TRH. A decrease in the percentage ratio of calcitonin to parathyrin was noted in the normal level of ionized calcium. Clinical signs of hypothyrosis in this case were noticeable. In hypophysial hypothyrosis (pangiopopituitarism) there was a decrease in the levels of calcitonin and parathyrin but their percentage ratio remained normal in a decreased level of ionized calcium.
本文关注甲状腺功能减退症的临床体征、甲状腺及钙调节功能的比较分析。发现促甲状腺激素（TSH）对促甲状腺激素释放激素（TRH）的反应降低或增加；同时伴有由降钙素、甲状旁腺素和离子钙水平所决定的钙调节功能紊乱，所有这些指标均根据K. I. 米什金提出的数学表格进行评估，该表格与甲状腺功能减退症体征的严重程度相关。在TSH对TRH反应增加的原发性甲状腺功能减退症中，观察到血液中降钙素水平升高。随着离子钙水平升高，降钙素与甲状旁腺素的百分比比值增加。甲状腺功能减退症的临床体征要么减轻要么完全消失，甲状旁腺功能减退症（相对性甲状旁腺功能减退症）的临床体征出现，这使得甲状腺功能减退症的诊断变得困难。在TSH对TRH反应不足的原发性甲状腺功能减退症中，降钙素含量降低。在离子钙水平正常时，降钙素与甲状旁腺素的百分比比值下降。在这种情况下，甲状腺功能减退症的临床体征明显。在垂体性甲状腺功能减退症（垂体血管病变）中，降钙素和甲状旁腺素水平降低，但在离子钙水平降低时它们的百分比比值仍保持正常。
