Rohmer V, Hocq R, Galland F, Getin F, Tadei A, Jallet P, Bigorgne J C
Presse Med. 1984 Jan 28;13(3):145-8.
The TRH test was used to detect hyperthyroidism in 87 patients aged from 38 to 85 years who presented with atrial arrhythmia with or without heart disease. The patients had no clinical evidence of thyrotoxicosis, and total thyroxine (T4), free thyroxine index (FTI) and triiodothyronine (T3) values were normal. Hyperthyroidism was diagnosed in the 18 patients (21%) with negative TRH test; 15 of them had high free thyroxine (FT4) levels. The most common causes of hyperthyroidism were "warm" nodules in 7 and iodine overload in 10. Adding an anti-thyroid treatment to the hitherto unsuccessful anti-arrhythmic treatment resulted in a return to sustained sinus rhythm in 50% of cases. FT4 levels became normal in all. This study indicates that all patients with atrial arrhythmia, with or without heart disease, should be investigated for occult hyperthyroidism. It also demonstrates the value of FT4 assays to detect the disease. The TRH test is only required as a second-line exploratory method in some patients, notably those with iodine overload.
促甲状腺激素释放激素（TRH）试验用于检测87例年龄在38至85岁之间、伴有或不伴有心脏病的房性心律失常患者是否患有甲状腺功能亢进症。这些患者无甲状腺毒症的临床证据，总甲状腺素（T4）、游离甲状腺素指数（FTI）和三碘甲状腺原氨酸（T3）值均正常。18例（21%）TRH试验阴性的患者被诊断为甲状腺功能亢进症；其中15例游离甲状腺素（FT4）水平升高。甲状腺功能亢进症最常见的病因是7例的“温”结节和10例的碘摄入过量。在迄今未成功的抗心律失常治疗基础上加用抗甲状腺治疗，50%的病例恢复为持续性窦性心律。所有患者的FT4水平均恢复正常。本研究表明，所有伴有或不伴有心脏病的房性心律失常患者均应检查是否存在隐匿性甲状腺功能亢进症。研究还证明了FT4检测对该病的诊断价值。TRH试验仅在部分患者中作为二线探索性方法使用，尤其是碘摄入过量的患者。
