Burger H G, Patel Y C
Clin Endocrinol Metab. 1977 Mar;6(1):83-100. doi: 10.1016/s0300-595x(77)80057-1.
The major determinant of serum TSH and its response to TRH is the interaction of TRH and the thyroid hormones (principally T3) at the level of the thyrotroph. Small changes in thyroid hormone levels within the normal range can produce marked alteration in thyrotroph sensitivity to TRH. Elevated serum TSH is of great diagnostic value in suspected primary hypothyroidism. The demonstration of a normal TSH response to TRH is valuable in excluding the diagnosis of hyperthyroidism, whereas a suppressed response is of lesser value in diagnosis, although characteristic of the hyperthyroid state. TSH responses to TRH are of limited value in the differentiation of hypothalamic from pituitary lesions, and cannot always be correlated with clinical or biochemical thyroid status.
血清促甲状腺激素（TSH）及其对促甲状腺激素释放激素（TRH）反应的主要决定因素是TRH与甲状腺激素（主要是T3）在促甲状腺细胞水平上的相互作用。正常范围内甲状腺激素水平的微小变化可导致促甲状腺细胞对TRH的敏感性发生显著改变。血清TSH升高在疑似原发性甲状腺功能减退症中具有重要诊断价值。TSH对TRH反应正常有助于排除甲状腺功能亢进症的诊断，而反应受抑制在诊断中的价值较小，尽管这是甲状腺功能亢进状态的特征。TSH对TRH的反应在区分下丘脑病变和垂体病变方面价值有限，且并不总是与临床或生化甲状腺状态相关。
