Maclean D, Taig D R, Emslie-Smith D
Br Med J. 1973 Apr 14;2(5858):87-90. doi: 10.1136/bmj.2.5858.87.
The photomotogram (P.M.G.) of the Achilles tendon reflex was studied in 26 patients with hypothermia (rectal temperature 33.3 degrees C or less), 10 of whom also had myxoedema (serum protein bound iodine 2.8 mug/100 ml or less). No reflex could be elicited in eight (31%) of these patients, including three of those with myxoedema. Hypothermia increases both the contraction and the relaxation times of the reflex, the relaxation phase being particularly prolonged in those with myxoedema. In those patients from whom the reflex was elicited the ratio of the contraction time to the "half-relaxation time" in the P.M.G. was less than unity in six of the seven with myxoedema, and considerably greater than unity in eight of the 11 (73%) who were euthyroid. Thus, analysis of the Achilles tendon reflex P.M.G. correctly predicted the thyroid status in 14 of the 18 hypothermic patients in whom the Achilles tendon reflex was present (78%). The wider use of this rapid test of thyroid function would allow a more rational use of thyroid hormones in hypothermic patients and so lead to a better assessment of their value.
对26例体温过低（直肠温度33.3摄氏度或更低）的患者进行了跟腱反射的光电描记图（P.M.G.）研究，其中10例还患有黏液性水肿（血清蛋白结合碘2.8微克/100毫升或更低）。这些患者中有8例（31%）无法引出反射，其中包括3例黏液性水肿患者。体温过低会增加反射的收缩和舒张时间，黏液性水肿患者的舒张期尤其延长。在那些引出反射的患者中，黏液性水肿的7例患者中有6例的P.M.G.中收缩时间与“半舒张时间”的比值小于1，而甲状腺功能正常的11例患者中有8例（73%）该比值远大于1。因此，对18例存在跟腱反射的体温过低患者中的14例（78%），跟腱反射P.M.G.分析正确预测了甲状腺状态。更广泛地使用这种快速甲状腺功能测试将使体温过低患者更合理地使用甲状腺激素，从而更好地评估其价值。
