Howorth P J, Ward R L
J Clin Pathol. 1972 Mar;25(3):259-62. doi: 10.1136/jcp.25.3.259.
The T(4)-free thyroxine index was used as the thyroid function test of first choice in a district general hospital for one year. Ninety-two patients were assessed both initially and at follow up by a single physician. The index agreed with clinical assessment in 69 out of 74 patients in whom diagnosis was unequivocal. There was initial doubt about thyroid status in 14 patients; after re-assessment the index agreed with status in seven cases, in three cases there is still some uncertainty, whilst the index was at variance with clinical status in four patients. Some possible causes of discrepancy between clinical thyroid status and the index are a low index in euthyroid patients due to a fall in serum thyroxine-binding prealbumin (;sick euthyroid'), a raised index in euthyroid patients due to latent thyroid heart disease, and a normal index in thyrotoxicosis due to preferential secretion of triiodothyronine.
在一家地区综合医院，游离甲状腺素指数作为首选的甲状腺功能检测指标使用了一年。92例患者由同一位医生进行了初始评估和随访评估。在74例诊断明确的患者中，该指数与临床评估结果相符的有69例。14例患者的甲状腺状态最初存在疑问；重新评估后，该指数与7例患者的状态相符，3例仍存在一些不确定性，而在4例患者中该指数与临床状态不一致。临床甲状腺状态与该指数之间存在差异的一些可能原因包括：甲状腺功能正常的患者由于血清甲状腺素结合前白蛋白下降（“病态甲状腺功能正常”）导致指数偏低；甲状腺功能正常的患者由于潜在的甲状腺心脏病导致指数升高；以及甲状腺毒症患者由于三碘甲状腺原氨酸优先分泌导致指数正常。
