Martino E, Pacchiarotti A, Aghini-Lombardi F, Grasso L, Bambini G, Baschieri L, Pinchera A
Acta Endocrinol (Copenh). 1985 Nov;110(3):354-9. doi: 10.1530/acta.0.1100354.
The serum free thyroxine concentration was measured by direct radioimmunoassay in 38 untreated T3-thyrotoxic patients with elevated serum total and free triiodothyronine, normal serum thyroxine and free thyroxine index, no TSH response to TRH, and with clinical evidence of hyperthyroidism. An elevation of circulating free thyroxine values was observed in 58% of the patients, whereas total serum thyroxine concentration was within the normal range. It is suggested, therefore, that T3-thyrotoxicosis should be reserved for patients with elevated serum total T3 and free T3 concentrations and normal serum total T4 and free T4 concentrations. Serum thyroxine-binding globulin concentrations were significantly lower (P less than 0.025) in patients with an elevated serum free thyroxine (18.7 +/- 3.6 micrograms/ml: mean +/- SD) as compared with those in patients with a normal free thyroxine concentration (23.4 +/- 2.6 micrograms/ml). In addition, no daily fluctuations in total and free thyroxine concentration were observed in 6 patients over a 4-8 day period.
采用直接放射免疫分析法对38例未经治疗的T3型甲状腺毒症患者的血清游离甲状腺素浓度进行了测定，这些患者血清总三碘甲状腺原氨酸和游离三碘甲状腺原氨酸升高，血清甲状腺素和游离甲状腺素指数正常，对促甲状腺激素释放激素（TRH）无促甲状腺激素（TSH）反应，且有甲状腺功能亢进的临床证据。58%的患者观察到循环游离甲状腺素值升高，而血清总甲状腺素浓度在正常范围内。因此，建议T3型甲状腺毒症应仅用于血清总T3和游离T3浓度升高而血清总T4和游离T4浓度正常的患者。血清游离甲状腺素升高的患者血清甲状腺素结合球蛋白浓度（18.7±3.6微克/毫升：均值±标准差）显著低于游离甲状腺素浓度正常的患者（23.4±2.6微克/毫升）（P<0.025）。此外，6例患者在4 - 8天期间未观察到总甲状腺素和游离甲状腺素浓度的每日波动。
