Schicha H, Emrich D, Schreivogel I
J Endocrinol Invest. 1985 Oct;8(5):399-407. doi: 10.1007/BF03348523.
An attempt was made to classify 326 patients with hyperthyroidism due to Graves' disease and due to autonomous goiter in an area of endemic iodine deficient goiter using the following two sets of criteria: Primary criteria: the presence of endocrine ophthalmopathy (Graves' disease) and the absence of endocrine ophthalmopathy and the absence of microsomal antibodies greater than or equal to 1:1600 (autonomous goiter). Sixty-nine percent of the patients could be divided in the two groups with the aid of these criteria. Secondary criteria: age greater than 50 years, presence of a goiter, presence of thyroid nodules, activity distribution in the scan, iodine intake determined by iodine excretion in the urine. These criteria had to be applied in the 31% of the patients who could not be divided into one of the two groups using the primary criteria. The secondary criteria were accumulative. Using these criteria 55% of the 326 patients were classified as having Graves' disease and 45% as having autonomous goiter. The probability of correct grouping when both primary and secondary criteria were applied was estimated to be 90% compared to 54% when we used only the classical terms, i.e. endocrine ophthalmopathy and diffuse goiter on the one hand and multinodular goiter without endocrine ophthalmopathy on the other hand. In a second group of 120 hyperthyroid patients classified in this way, thyrotropin displacing activity was determined independently. Its prevalence was 79% in patients classified as having Graves' disease but only 3% in those classified as having autonomous goiter. The prevalence of TDA observed in patients who presumably had autonomous goiter was in the same range as in the following groups: 45 normal individuals; 126 patients with euthyroid goiter; and in 112 patients with euthyroid and hyperthyroid autonomous adenoma.(ABSTRACT TRUNCATED AT 250 WORDS)
尝试使用以下两组标准，对某地方性碘缺乏性甲状腺肿地区的326例格雷夫斯病所致甲亢患者和自主性甲状腺肿所致甲亢患者进行分类：主要标准：存在内分泌性眼病（格雷夫斯病），不存在内分泌性眼病且微粒体抗体小于1:1600（自主性甲状腺肿）。借助这些标准，69%的患者可分为两组。次要标准：年龄大于50岁、存在甲状腺肿、存在甲状腺结节、扫描中的活性分布、通过尿碘排泄测定的碘摄入量。这些标准必须应用于31%无法使用主要标准分为两组的患者。次要标准是累积性的。使用这些标准，326例患者中有55%被分类为患有格雷夫斯病，45%被分类为患有自主性甲状腺肿。应用主要和次要标准时正确分组的概率估计为90%，而仅使用经典术语时为54%，即一方面是内分泌性眼病和弥漫性甲状腺肿，另一方面是无内分泌性眼病的多结节性甲状腺肿。在以这种方式分类的第二组120例甲亢患者中，独立测定促甲状腺素置换活性。其在被分类为患有格雷夫斯病的患者中的患病率为79%，但在被分类为患有自主性甲状腺肿的患者中仅为3%。在推测患有自主性甲状腺肿的患者中观察到的促甲状腺素置换活性患病率与以下组相同：45名正常个体；126例甲状腺功能正常的甲状腺肿患者；以及112例甲状腺功能正常和甲亢的自主性腺瘤患者。（摘要截断于250字）
