Hesse V, Lauterbach H, Stoll W
Klin Wochenschr. 1977 Feb 1;55(3):131-5. doi: 10.1007/BF01490240.
TRH-tests, triiodothyronine (T3), TBI, and thyroxine (T4) determinations were carried out in 23 children with primary hypothyroidism treated with T3/T4-preparations. T3/T4 quotients were calculated. 7 out of 10 patients with TRH refractory TSH values and normal T4 levels had T3 values above normal range. In 6 of them pathologically elevated T3/T4 quotients could be observed. A TSH refractory TSH suppression was only found in patients with superior normal T4 values. After a reduction of the replacement doses the T3 values were normal. The findings show--that not only the T4 values should be controlled under treatment with thyroid preparations but also the T3 and TSH serum levels. The replacement therapy of hypothyroidism with T3/T4 preparations in proportion 1:4 should be revised.
对23例接受T3/T4制剂治疗的原发性甲状腺功能减退症患儿进行了促甲状腺激素释放激素（TRH）试验、三碘甲状腺原氨酸（T3）、甲状腺结合指数（TBI）和甲状腺素（T4）测定。计算了T3/T4比值。10例TRH难治性促甲状腺激素（TSH）值且T4水平正常的患者中有7例T3值高于正常范围。其中6例可观察到T3/T4比值病理性升高。仅在T4值高于正常的患者中发现TSH难治性TSH抑制。减少替代剂量后，T3值恢复正常。研究结果表明，在用甲状腺制剂治疗期间，不仅应监测T4值，还应监测T3和TSH血清水平。应以1:4比例使用T3/T4制剂替代治疗甲状腺功能减退症的疗法应予以修订。
