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甲状腺功能的生化检查在监测接受甲状腺素替代治疗的患者方面有任何价值吗？

Are biochemical tests of thyroid function of any value in monitoring patients receiving thyroxine replacement?

作者信息

Fraser W D, Biggart E M, O'Reilly D S, Gray H W, McKillop J H, Thomson J A

出版信息

Br Med J (Clin Res Ed). 1986 Sep 27;293(6550):808-10. doi: 10.1136/bmj.293.6550.808.

DOI:10.1136/bmj.293.6550.808
PMID:3094667
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1341585/
Abstract

To establish their role in monitoring patients receiving thyroxine replacement biochemical tests of thyroid function were performed in 148 hypothyroid patients studied prospectively. Measurements of serum concentrations of total thyroxine, analogue free thyroxine, total triiodothyronine, analogue free triiodothyronine, and thyroid stimulating hormone, made with a sensitive immunoradiometric assay, did not, except in patients with gross abnormalities, distinguish euthyroid patients from those who were receiving inadequate or excessive replacement. These measurements are therefore of little, if any, value in monitoring patients receiving thyroxine replacement. To stop doing thyroid function tests in these cases would result in considerable savings nationally in the cost of reagents in laboratories using commercial kits.

摘要

为确定甲状腺功能生化检测在监测接受甲状腺素替代治疗患者中的作用，我们对148例甲状腺功能减退患者进行了前瞻性研究。采用灵敏的免疫放射分析方法测定血清总甲状腺素、类似物游离甲状腺素、总三碘甲状腺原氨酸、类似物游离三碘甲状腺原氨酸以及促甲状腺激素的浓度，结果显示，除了存在明显异常的患者外，这些检测无法区分甲状腺功能正常的患者与接受替代治疗不足或过量的患者。因此，这些检测在监测接受甲状腺素替代治疗的患者时，即便有价值，也微乎其微。在这些情况下停止进行甲状腺功能检测，将在全国范围内大幅节省使用商业试剂盒的实验室的试剂成本。

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Relationships between circulating and intracellular thyroid hormones: physiological and clinical implications.循环甲状腺激素与细胞内甲状腺激素之间的关系：生理及临床意义
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