Jaffiol C, Baldet L, Castelnau P, Aberlenc M, Mirouze J
Ann Endocrinol (Paris). 1978;39(1):61-2.
32 patients with Graves' Disease were investigated before treatment, during ATD therapy and after recovery with a normal T3 suppression test. Before treatment, TRH response was negative with elevated values of plasma TT4, AFT4, TT3 and AFT3. The 3d, 6 - 9 and 12-18 months and after recovery, several patients remained unresponders to TRH despite normal AFT4 and AFT3 in serum. In an opposite way some patients were responders, 1 month after ATD withdrawal, at the 6-9 month, with elevated values of AFT4 or AFT3. The discrepancy between TRH response and T3 suppression test is pointed out after recovery. The unresponsiveness of TSH to TRH unexplained by serum AFT4 or AFT3 may be due to : 1) a decrease in pituitary TSH stores. 2) an unknown factor inhibiting TSH release during Graves' disease 3) an hypersensitivity of thyreotrop cells to T3.
对32例格雷夫斯病患者在治疗前、抗甲状腺药物（ATD）治疗期间以及T3抑制试验恢复正常后进行了研究。治疗前，TRH反应为阴性，血浆总甲状腺素（TT4）、游离甲状腺素（FT4）、总三碘甲状腺原氨酸（TT3）和游离三碘甲状腺原氨酸（FT3）值升高。在3个月、6 - 9个月、12 - 18个月以及恢复后，尽管血清中FT4和FT3正常，但仍有若干患者对TRH无反应。相反，一些患者在停用ATD 1个月后、6 - 9个月时，FT4或FT3值升高，对TRH有反应。恢复后指出了TRH反应与T3抑制试验之间的差异。血清FT4或FT3无法解释的TSH对TRH无反应可能是由于：1）垂体TSH储备减少。2）格雷夫斯病期间抑制TSH释放的未知因素。3）促甲状腺细胞对T3过敏。
