Biersack H J, Albrecht W, Oehr P, Rasche A, Winkler C
Dtsch Med Wochenschr. 1983 Aug 26;108(34):1269-73. doi: 10.1055/s-2008-1069733.
303 patients with non-toxic goitre (aged 14-85 years) were studied to determine the extent to which the level of thyroid-hormone dosage until a negative TRH test is reached can be defined in terms of age, body surface area and goitre size. In all instances detailed examination had determined regular hormone intake. The required L-thyroxine dose (until negative TRH test) was 100 micrograms/d in 75.6% of cases, 125 micrograms/d in 9.2% and 150 micrograms/d in 8.6% of cases. In 2.6% of cases was a satisfactory suppression reached at 50 microgram/d and in 4% at 75 micrograms/d. There was no correlation of the level of L-thyroxine dose to body surface area, age, T3 level, delta-TSH or goitre size. There was a slight correlation between T4 level and optimal L-thyroxine dose, but not significant because of the wide range of normal. The results indicate that the only way to obtain optimal L-thyroxine dosage in the treatment of goitre is by doing a TRH test in the given patient.
对303例非毒性甲状腺肿患者(年龄14 - 85岁)进行了研究,以确定在达到TRH试验阴性之前,甲状腺激素剂量水平在多大程度上可以根据年龄、体表面积和甲状腺肿大小来确定。在所有病例中,详细检查均确定了规律的激素摄入情况。达到TRH试验阴性所需的左旋甲状腺素剂量在75.6%的病例中为100微克/天,在9.2%的病例中为125微克/天,在8.6%的病例中为150微克/天。在2.6%的病例中,50微克/天的剂量达到了满意的抑制效果,在4%的病例中,75微克/天的剂量达到了满意的抑制效果。左旋甲状腺素剂量水平与体表面积、年龄、T3水平、△TSH或甲状腺肿大小均无相关性。T4水平与最佳左旋甲状腺素剂量之间存在轻微相关性,但由于正常范围较宽,故无统计学意义。结果表明,在甲状腺肿治疗中获得最佳左旋甲状腺素剂量的唯一方法是对特定患者进行TRH试验。