Schlienger J L, De Laharpe F, Reville P, Stephan F
Sem Hop. 1980;56(17-18):827-31.
Primary hypothyroidism is assessed by increased basal and TRH-induced TSH levels. Since basal and TRH induced prolactin (PRL) levels may also be modified by the thyroid status, TSH and PRL responses to TRH are simultaneously determined in patients with mild or evident primary hypothyroidism (n = 22) and in TSH hyperresponders (n = 28) with clinicobiological appearance of euthyroidism. In evident hypothyroidism (free thyroxine index FT4 I = 0,4 +/- 0,1) basal PRL are increased in 8 out of 11 patients and TRH-induced PRL responses are exaggerated in all cases like in mild hypothyroidism (FT 4 I = 1,2 +/- 0, 1) A negative correlation is found between maximal PRL levels and triiodothyronine (T3) levels (p less than 0,01). In presumed euthyroid TSH hyperresponders (FT4 I = 2,2 +/- 0,1) PRL response to TRH is exaggerated in only 7 patients and no correlation exists between maximal PRL and T3 levels. These data suggest that simultaneously exaggerated TSH and PRL responses to TRH are presumably patterns of potential hyperthyroidism for the diagnosis of which the determination of TSH alone seems to be necessary but insufficient.
原发性甲状腺功能减退通过基础及促甲状腺激素释放激素(TRH)刺激后促甲状腺激素(TSH)水平升高来评估。由于基础及TRH刺激后的催乳素(PRL)水平也可能受甲状腺状态影响,因此,我们同时测定了轻度或明显原发性甲状腺功能减退患者(n = 22)以及临床生物学表现为甲状腺功能正常的TSH高反应者(n = 28)对TRH的TSH和PRL反应。在明显甲状腺功能减退患者(游离甲状腺素指数FT4 I = 0.4 ± 0.1)中,11例患者中有8例基础PRL升高,且所有病例中TRH刺激后的PRL反应均增强,轻度甲状腺功能减退患者(FT4 I = 1.2 ± 0.1)也是如此。PRL最高水平与三碘甲状腺原氨酸(T3)水平呈负相关(p < 0.01)。在假定甲状腺功能正常的TSH高反应者(FT4 I = 2.2 ± 0.1)中,仅7例患者对TRH的PRL反应增强,且PRL最高水平与T3水平之间无相关性。这些数据表明,TSH和PRL对TRH的反应同时增强可能是潜在甲状腺功能亢进的模式,对于其诊断,仅测定TSH似乎有必要但并不充分。