Thornes H M, McLeod D T, Carr D
Clin Chem. 1987 Sep;33(9):1635-8.
We measured thyrotropin (TSH) with a sensitive immunoradiometric assay (IRMA) in 2329 consecutive serum samples received for thyroid-function tests from hospital and general practice. Of these, 185 (7.9%) had TSH values less than 0.2 milli-int. unit/L: 33 (1.4%) were hyperthyroid, 20 (0.9%) were being treated for hyperthyroidism, 115 (4.9%) were receiving L-thyroxin, and 17 (0.7%) were clinically euthyroid but had severe non-thyroidal illnesses. In the first 506 serum samples, we also measured free thyroxin, free triiodothyronine (FT3), and total thyroxin. Thyroliberin (thyrotropin-releasing hormone, TRH) tests performed on 84 patients showed that an undetectable initial TSH (usually ascribable to therapy with thyroxin) predicted a flat TRH response. All untreated thyrotoxic patients had undetectable TSH. Experience confirmed that this TSH assay, in conjunction with a supplementary assay of FT3 when the TSH concentration is less than twice the limit of detection, is efficient and economical for routine evaluation of thyroid function in an unselected population.
我们采用灵敏免疫放射分析（IRMA）法，对从医院和普通诊所接收的2329份用于甲状腺功能检测的连续血清样本进行促甲状腺激素（TSH）测定。其中，185份（7.9%）TSH值低于0.2毫国际单位/升：33份（1.4%）为甲状腺功能亢进，20份（0.9%）正在接受甲状腺功能亢进治疗，115份（4.9%）正在接受左旋甲状腺素治疗，17份（0.7%）临床甲状腺功能正常但患有严重非甲状腺疾病。在最初的506份血清样本中，我们还检测了游离甲状腺素、游离三碘甲状腺原氨酸（FT3）和总甲状腺素。对84例患者进行的促甲状腺素释放激素（TRH）试验表明，初始TSH检测不到（通常归因于甲状腺素治疗）预示着TRH反应平淡。所有未经治疗的甲状腺毒症患者TSH均检测不到。经验证实在对未选人群进行甲状腺功能常规评估时，该TSH检测法，以及在TSH浓度低于检测限两倍时辅以FT3检测，高效且经济。
