Ratnaike S, Goodwin M, Deam D
Clin Chem. 1987 Jul;33(7):1213-4.
We studied problems associated with use of an "ultrasensitive" thyrotropin (TSH, thyroid-stimulating hormone) assay for diagnosis of hyperthyroidism. Of 955 TSH assays performed in our laboratory during four months, 135 gave TSH values less than 0.1 milli-int. unit/L. We noted low TSH values at all concentrations of free thyroxin (FT4) in plasma. Nine of 13 patients with a normal or low FT4 and no obvious endocrine explanation for a low TSH were elderly and ill. This raises questions about the pituitary function in such patients. Twenty-seven patients who had high FT4 and non-suppressed TSH were clinically euthyroid, 20 of them being on treatment with thyroxin or amiodarone. Low TSH values in a hospital environment do not always indicate hyperthyroidism, although a normal value for TSH probably indicates euthyroidism.
我们研究了使用“超敏”促甲状腺激素（TSH，甲状腺刺激激素）检测法诊断甲状腺功能亢进症相关的问题。在四个月期间于我们实验室进行的955次TSH检测中，有135次的TSH值低于0.1毫国际单位/升。我们注意到血浆中所有游离甲状腺素（FT4）浓度下TSH值均较低。13例FT4正常或偏低且TSH降低无明显内分泌学解释的患者中有9例为老年且患病。这引发了对此类患者垂体功能的疑问。27例FT4升高且TSH未被抑制的患者临床甲状腺功能正常，其中20例正在接受甲状腺素或胺碘酮治疗。在医院环境中TSH值低并不总是表明甲状腺功能亢进，尽管TSH值正常可能表明甲状腺功能正常。
