Schlienger J L, Sapin R, Chabrier G, Gasser F, Simon C, Cherfan J, Chambron J
Pathol Biol (Paris). 1986 Dec;34(10):1087-90.
A new ultrasensitive TSH immunoradiometric assay (IRMA) using two monoclonal antibodies is now able to distinguish between euthyroid and hyperthyroid patients. The aim of this study was to compare data given by ultrasensitive basal TSH (IRMA) and by the response of TSH to TRH test considered until now as the more reliable test in case of mild or atypical hyperthyroidism. Basal plasma TSH levels were determined in euthyroid (n = 80), hyperthyroid (n = 30), hypothyroid (n = 14) and pituitary deficient patients (n = 8) before and 30 minutes after a TRH test (250 micrograms i.v.). A close linear correlation was found between basal and post-stimulative TSH levels. Normal TSH response ranged from 2 to 22 uU/ml. The sensibility and the specificity of these two parameters appeared comparable in the case of primary dysthyroidism; on the contrary basal TSH levels were not sufficient for the diagnosis of central hypothyroidism. In conclusion, excepted for pituitary deficiency, basal plasma TSH (IRMA) levels are accurate and sufficient in the evaluation of the thyroid function and make the TRH-test useless.
一种使用两种单克隆抗体的新型超灵敏促甲状腺激素免疫放射测定法（IRMA）现在能够区分甲状腺功能正常和甲状腺功能亢进的患者。本研究的目的是比较超灵敏基础促甲状腺激素（IRMA）给出的数据以及促甲状腺激素对促甲状腺激素释放激素（TRH）试验的反应，迄今为止，在轻度或非典型甲状腺功能亢进的情况下，TRH试验被认为是更可靠的检测方法。在进行TRH试验（静脉注射250微克）之前和之后30分钟，测定了甲状腺功能正常（n = 80）、甲状腺功能亢进（n = 30）、甲状腺功能减退（n = 14）和垂体功能减退患者（n = 8）的基础血浆促甲状腺激素水平。发现基础促甲状腺激素水平与刺激后促甲状腺激素水平之间存在密切的线性相关性。正常促甲状腺激素反应范围为2至22微单位/毫升。在原发性甲状腺功能障碍的情况下，这两个参数的敏感性和特异性似乎相当；相反，基础促甲状腺激素水平不足以诊断中枢性甲状腺功能减退。总之，除垂体功能减退外，基础血浆促甲状腺激素（IRMA）水平在评估甲状腺功能方面准确且足够，使得TRH试验变得无用。
