Caplan R H, Glasser J E, Davis K, Foster L, Wickus G
J Am Geriatr Soc. 1978 Mar;26(3):116-20. doi: 10.1111/j.1532-5415.1978.tb01220.x.
Several tests of thyroid function were performed in 35 hyperthyroid patients over the age of 65 (elderly). The results were compared to those of similar tests in 48 hyperthyroid patients under the age of 65 (young). Total serum thyroxine (T4) was within the normal range in 14 percent of the elderly and 11 percent of the young hyperthyroid patients. The free thyroxine index (FTI) was within the normal range in 11 percent of both groups. The triiodothyronine uptake (T3U) proved to be a poor test in both groups. Although elevation of the triiodothyronine (T3) level allowed a diagnosis of "T3-toxicosis" in 2 elderly and 3 young hyperthyroid patients, the T3 level was normal in 34 percent of the elderly and 13 percent of the young subjects. Correction of the T3 range for age reduced the number of normal T3 values to 12.5 percent in the elderly hyperthyroid patients. The 24-hour uptake of radioactive iodine was normal in 12 percent of the young hyperthyroid patients, 27 percent of the elderly patients with Graves' disease, and 70 percent of the elderly patients with toxic nodular goiter, despite recent readjustment of the normal range for the test. It is concluded that the diagnosis of hyperthyroidism in the elderly may be difficult and that no single test can be relied upon to exclude the diagnosis.
对35名65岁以上（老年）的甲亢患者进行了多项甲状腺功能测试。将结果与48名65岁以下（年轻）的甲亢患者的类似测试结果进行了比较。老年甲亢患者中14%的血清总甲状腺素（T4）在正常范围内，年轻甲亢患者中这一比例为11%。两组中11%的患者游离甲状腺素指数（FTI）在正常范围内。两组中三碘甲状腺原氨酸摄取率（T3U）测试结果均不佳。尽管2名老年和3名年轻甲亢患者的三碘甲状腺原氨酸（T3）水平升高可诊断为“T3中毒症”，但老年受试者中34%、年轻受试者中13%的T3水平正常。根据年龄校正T3范围后，老年甲亢患者中T3值正常的比例降至12.5%。尽管最近对该测试的正常范围进行了重新调整，但年轻甲亢患者中12%、老年格雷夫斯病患者中27%、老年毒性结节性甲状腺肿患者中70%的放射性碘24小时摄取率正常。结论是，老年甲亢的诊断可能很困难，而且没有单一的测试可以依靠来排除诊断。
