Blichert-Toft M, Christiansen C, Axelsson C K, Egedorf J, Ibsen H, Ibsen J
Clin Endocrinol (Oxf). 1978 Feb;8(2):95-100. doi: 10.1111/j.1365-2265.1978.tb02157.x.
Absent thyrotrophin (TSH) response to thyrotrophin releasing hormone (TRH) was found in ten of fifty consecutive nodular goitrous patients who were clinically and biochemically euthyroid. These ten patients together with a reference group engaging fifty-eight healthy individuals matched for sex, age, and geographic region form the basis of the present study. Patients with autonomously functioning single adenomata were excluded from the investigation. In the patient group, values of serum thyroxine (T4), free T4-index, and serum TSH did not differ significantly from those recorded in the reference group, whereas serum triiodothyronine was found to be significantly higher in the patients, although within the normal range. After selective resection of the goitre, the TSH responsiveness to TRH recovered completely. Routine indices of thyroid function, however, demonstrated no major deviation from pre-operative levels. During a follow-up period of 1 year, no systematic alterations were recorded in TSH response to TRH nor in the thyroid function tests, indicating maintenance of euthyroidism with restored normality within the pituitary-thyroid axis. The present study lends support to the view that increasing functional autonomy apparently is a common trend in goitre evolution in a non-endemic area.
在连续50例临床及生化检查均为甲状腺功能正常的结节性甲状腺肿患者中，发现有10例对促甲状腺激素释放激素（TRH）无促甲状腺激素（TSH）反应。这10例患者与一组由58名性别、年龄及地理区域相匹配的健康个体组成的参照组共同构成了本研究的基础。自主功能的单发腺瘤患者被排除在研究之外。在患者组中，血清甲状腺素（T4）、游离T4指数及血清TSH值与参照组记录值相比无显著差异，而患者血清三碘甲状腺原氨酸虽在正常范围内，但明显高于参照组。甲状腺肿选择性切除术后，TSH对TRH的反应完全恢复。然而，甲状腺功能的常规指标与术前水平相比无重大偏差。在1年的随访期内，TSH对TRH的反应及甲状腺功能检查均未出现系统性改变，表明垂体 - 甲状腺轴恢复正常，甲状腺功能正常得以维持。本研究支持这样一种观点，即在非地方性甲状腺肿流行地区，甲状腺肿演变过程中功能自主性增强显然是一种普遍趋势。
