Piketty M L, Talbot J N, Askienazy S, Milhaud G
Clin Chem. 1987 Jul;33(7):1237-41.
We compared results of five sensitive immunometric assays of serum thyrotropin (TSH) in controls and in different groups of patients with hyperthyroidism, untreated or treated; secondary hypothyroidism; nonthyroidal illness (NTI); or depression; or who were being treated with amiodarone. With most kits, measured TSH concentrations did not overlap between controls and hyperthyroid patients. In untreated secondary hypothyroidism TSH was not always undetectable. Patients with NTI and depression showed many low TSH values, and among these categories of patients, we observed large discrepancies among the kits. This lack of specificity at low concentration means that one cannot assess hyperthyroidism by TSH measurement alone, but it can be used as the first screening test. Similarly, TSH determination cannot be used alone in monitoring therapy (e.g., with carbimazole, thyroxin, amiodarone) to assess the presence of hyperthyroidism. Nonetheless, this assay plays a well-established role in hypothyroidism detection. Four of the five kits were found useful for clinical evaluation, the fifth less so.
我们比较了五种敏感的血清促甲状腺激素（TSH）免疫测定法在对照组以及不同组别的甲状腺功能亢进患者（未治疗或已治疗）、继发性甲状腺功能减退患者、非甲状腺疾病（NTI）患者、抑郁症患者或正在接受胺碘酮治疗的患者中的检测结果。使用大多数试剂盒时，对照组和甲状腺功能亢进患者的TSH测量浓度没有重叠。在未经治疗的继发性甲状腺功能减退中，TSH并非总是无法检测到。NTI患者和抑郁症患者有许多低TSH值，并且在这些患者类别中，我们观察到不同试剂盒之间存在很大差异。低浓度时缺乏特异性意味着不能仅通过TSH测量来评估甲状腺功能亢进，但它可以用作首次筛查试验。同样，在监测治疗（如使用卡比马唑、甲状腺素、胺碘酮）以评估是否存在甲状腺功能亢进时，不能单独使用TSH测定。尽管如此，该检测在甲状腺功能减退的检测中发挥着既定的作用。发现五种试剂盒中有四种可用于临床评估，第五种则不太适用。
