Aagaard J, Blichert-Toft M, Axelsson C K, Christiansen C
Acta Chir Scand. 1984;150(2):123-7.
The free thyroxine index (FT4I), triiodothyronine (T3) and thyroid stimulating hormone (TSH) in serum and the peak serum TSH (TRH test) were measured in 18 patients with nontoxic uninodular goitre and 32 patients with nontoxic multinodular goitre before and 3, 6, 12, 24 and 36 months after goitre resection. Thyroid hormone therapy was not given postoperatively. Resection of non-toxic goitre provoked a transient rise in TSH baseline level, with peak about one year after surgery. Three years after the resection the TSH baseline had returned to the preoperative level. The TSH changes were significantly more pronounced in the multinodular goitrous group, in which resection was bilateral, than in the uninodular goitrous group. The changes in serum FT4I and serum T3 were of moderate degree and most pronounced in the multinodular group. During long-term observation, serum FT4I increased slightly but significantly in both groups, but serum T3 showed significant reduction, albeit within reference range. The results of the study suggest that thyroid hormone therapy as a routine procedure after simple goitre resection lacks a tenable rational basis.
对18例非毒性单结节性甲状腺肿患者和32例非毒性多结节性甲状腺肿患者，在甲状腺肿切除术前以及术后3、6、12、24和36个月，测定血清游离甲状腺素指数（FT4I）、三碘甲状腺原氨酸（T3）和促甲状腺激素（TSH），以及血清TSH峰值（促甲状腺激素释放激素试验）。术后未给予甲状腺激素治疗。非毒性甲状腺肿切除术后TSH基线水平出现短暂升高，术后约一年达到峰值。切除术后三年，TSH基线恢复到术前水平。多结节性甲状腺肿组（双侧切除）TSH的变化比单结节性甲状腺肿组明显更显著。血清FT4I和血清T3的变化程度中等，在多结节性组中最为明显。在长期观察中，两组血清FT4I均略有但显著升高，但血清T3虽在参考范围内仍显著降低。研究结果表明，单纯性甲状腺肿切除术后作为常规程序进行甲状腺激素治疗缺乏合理依据。
