Fukino O, Tamai H, Fujii S, Ohsako N, Matsubayashi S, Kuma K, Nagataki S
Acta Endocrinol (Copenh). 1983 May;103(1):28-33. doi: 10.1530/acta.0.1030028.
Of 305 patients who underwent subtotal thyroidectomy for Graves' disease between 1969 and 1975, recurrent hyperthyroidism was found in 31 (10.2%) and hypothyroidism in 18 (5.9%). The remaining 256 patients were clinically euthyroid, but an elevated serum TSH level was found in 104 (34.1%) and an elevated serum T3 level in 19 (6.28%). In 57 of 133 clinically and biochemically euthyroid patients, a TRH test, T3 suppression test and measurement of antithyroid antibodies were performed. Twenty-nine of the 57 patients (50.9%) showed an abnormal response to TRH. Eight of these (14.0%) showed an impaired or absent response. The T3 suppression test showed that 15 of the 57 patients (26.3%) were non-suppressible. Positive antithyroid antibodies, especially antimicrosomal antibodies, were more frequent in non-suppressible and TRH-non-responsive patients than in suppressible and TRH-responsive patients. It is suggested that after operation for Graves' disease: 1) only half of the clinically euthyroid patients were biochemically euthyroid, 2) of the clinically and biochemically euthyroid patients, there were many with abnormalities in TRH responsiveness and T3 suppressibility, and 3) thyroid functional status is unstable and long careful follow-up is important after operation for Graves' disease.
在1969年至1975年间因格雷夫斯病接受甲状腺次全切除术的305例患者中，发现31例（10.2%）复发甲亢，18例（5.9%）出现甲减。其余256例患者临床甲状腺功能正常，但104例（34.1%）血清促甲状腺激素（TSH）水平升高，19例（6.28%）血清三碘甲状腺原氨酸（T3）水平升高。在133例临床和生化检查甲状腺功能正常的患者中，对其中57例进行了促甲状腺激素释放激素（TRH）试验、T3抑制试验及抗甲状腺抗体检测。57例患者中有29例（50.9%）对TRH试验反应异常。其中8例（14.0%）反应受损或无反应。T3抑制试验显示，57例患者中有15例（26.3%）不受抑制。抗甲状腺抗体阳性，尤其是微粒体抗体，在T3抑制试验不受抑制和TRH试验无反应的患者中比在可抑制和TRH试验有反应的患者中更常见。提示格雷夫斯病手术后：1）仅一半临床甲状腺功能正常的患者生化检查甲状腺功能正常；2）临床和生化检查甲状腺功能正常的患者中，许多患者存在TRH反应性及T3抑制性异常；3）甲状腺功能状态不稳定，格雷夫斯病手术后需长期密切随访。
