Kaptein E M
J Endocrinol Invest. 1986;9 Suppl 4:37-46.
Free T4 estimates by equilibrium dialysis appear to reflect serum free T4 levels in vivo in patients with nonthyroidal illnesses. However, patients with either elevated or modestly reduced free T4 values appear to be clinically euthyroid and have relatively normal free T4 availability to tissues as judged by the normal production rates of reverse T3 from T4, and by the minimally altered TSH status. Thus, increased or modestly reduced serum free T4 levels by equilibrium dialysis in patients with nonthyroidal illnesses do not appear to indicate the presence of overt T4 excess or deficiency, respectively, and, therefore, the clinician should strive to avoid unnecessary and potentially harmful therapy in these patients. Conversely, concurrent thyroid gland disease may be present which must be accurately diagnosed and treated to alleviate the morbidity induced by hyperthyroidism or hypothyroidism in sick patients.
通过平衡透析法估算的游离甲状腺素（Free T4）似乎能反映非甲状腺疾病患者体内的血清游离甲状腺素水平。然而，游离甲状腺素值升高或轻度降低的患者在临床上似乎甲状腺功能正常，并且从甲状腺素生成反三碘甲状腺原氨酸的正常速率以及甲状腺刺激激素（TSH）状态变化极小来判断，其组织中游离甲状腺素的可利用性相对正常。因此，非甲状腺疾病患者通过平衡透析法测得的血清游离甲状腺素水平升高或轻度降低，似乎并不分别表明存在明显的甲状腺素过量或不足，所以，临床医生应尽量避免对这些患者进行不必要的、可能有害的治疗。相反，可能同时存在甲状腺疾病，必须准确诊断并治疗，以减轻患病患者因甲状腺功能亢进或减退引起的发病率。
