Tunbridge W M, Harsoulis P, Goolden A W
Br Med J. 1974 Jul 13;3(5923):89-92. doi: 10.1136/bmj.3.5923.89.
A series of 105 patients treated at least two years earlier with radioactive iodine for thyrotoxicosis have been surveyed. Eighty-five patients (81%) were euthyroid clinically and on the basis of routine thyroid function tests. Of the euthyroid patients 46 (54%) had normal thyroid-stimulating hormone (TSH) levels and 39 (46%) had raised TSH levels. There was no difference in serum triiodothyronine levels between these two groups but the serum protein bound iodine and serum thyroxine, though still well within the normal range, were significantly lower in the group with raised TSH levels. The serum cholesterol was also significantly higher in this latter group.Most of the euthyroid patients were seen again a year later. None had become hypothyroid and neither those with normal nor those with raised TSH levels showed any evidence of a decline in the level of serum thyroxine.It is concluded that raised serum TSH levels in patients treated with iodine-131 are not necessarily indicative of hypothyroidism. There is no indication that patients who have this abnormality become overtly hypothyroid over a 12-month follow up.
对一系列至少在两年前接受放射性碘治疗甲状腺毒症的105例患者进行了调查。85例患者(81%)临床及根据常规甲状腺功能检查结果均处于甲状腺功能正常状态。在这些甲状腺功能正常的患者中,46例(54%)促甲状腺激素(TSH)水平正常,39例(46%)TSH水平升高。这两组之间血清三碘甲状腺原氨酸水平无差异,但血清蛋白结合碘和血清甲状腺素,虽仍完全在正常范围内,但在TSH水平升高的组中显著较低。后一组的血清胆固醇也显著较高。
大多数甲状腺功能正常的患者在一年后再次接受检查。无人出现甲状腺功能减退,TSH水平正常和升高的患者均未显示血清甲状腺素水平有下降的迹象。
接受碘-131治疗的患者血清TSH水平升高不一定表明甲状腺功能减退。没有迹象表明有这种异常的患者在12个月的随访中会明显出现甲状腺功能减退。