Tajiri J, Hamasaki S, Shimada T, Morita M, Higashi K, Ohishi S, Sato T
Jpn Heart J. 1986 Mar;27(2):183-90. doi: 10.1536/ihj.27.183.
Seventy-five elderly patients with atrial fibrillation (41 males and 34 females with a mean age of 75.6 years) were studied to evaluate the incidence of masked thyroid dysfunction. A thyrotropin (TSH)-releasing-hormone (TRH) test (intravenous injection of 250 micrograms of synthetic TRH) was performed in the patients and 30 age matched controls without atrial fibrillation. In the controls, no abnormal TRH stimulated TSH response was observed. In the patients with atrial fibrillation, no response of TSH to TRH (hyperthyroidism) was found in 5 cases (6.6%), while hyperresponse of TSH to TRH (hypothyroidism) was found in 6 cases (8.0%). Thyroid dysfunction (hyper or hypothyroidism) was more frequently observed in the patients than in the controls (p less than 0.05). Two of 5 hyperthyroid patients had normal thyroid hormone levels. All patients with hyperthyroidism were treated with antithyroid drugs or 131I. Unfortunately, atrial fibrillation persisted in all but 1 case. It is concluded that the TRH test is a useful screening test for detecting those patients with abnormal thyroid function among elderly patients with atrial fibrillation, and that hypothyroidism should be considered as a cause of atrial fibrillation in the elderly.
对75例老年房颤患者（41例男性，34例女性，平均年龄75.6岁）进行研究，以评估隐匿性甲状腺功能障碍的发生率。对这些患者以及30名年龄匹配的无房颤对照者进行促甲状腺激素（TSH）释放激素（TRH）试验（静脉注射250微克合成TRH）。在对照者中，未观察到异常的TRH刺激TSH反应。在房颤患者中，5例（6.6%）未发现TSH对TRH的反应（甲状腺功能亢进），而6例（8.0%）发现TSH对TRH的反应过度（甲状腺功能减退）。与对照者相比，患者中甲状腺功能障碍（甲状腺功能亢进或减退）的发生率更高（p<0.05）。5例甲状腺功能亢进患者中有2例甲状腺激素水平正常。所有甲状腺功能亢进患者均接受抗甲状腺药物或131I治疗。不幸的是，除1例患者外，其余患者的房颤均持续存在。结论是，TRH试验是检测老年房颤患者中甲状腺功能异常患者的有用筛查试验，并且甲状腺功能减退应被视为老年房颤的一个病因。
