Rinck P A, Botsch H, Rossdeutscher R
Rofo. 1981 Feb;134(2):198-200. doi: 10.1055/s-2008-1056335.
The authors determined values for T3, T4, T7, T3RIA and basal TSH, as well as TSH stimulation after intravenous administration of TRH in 998 patients. The test was negative in 259 patients (26%); in 51 of these patients (5.1%) no clinical or laboratory reasons could be found (low- or non-responders). In this group of patients the TRH test was repeated using a hundred times greater dose orally; in 27 cases (54%) of the low- or non-responders the oral test proved positive. In total, the TRH test was positive in 76.8%, negative in 20.9% and there were 2.3% non-responders. It was concluded that the oral test is more informative than the intravenous. Since the intravenous test gives poor results in only 5.1% of euthyroid patients, the extra effort appears hardly worth while. Further, failure of the intravenous TRH tests should lead to a repetition of the TRH test using oral application before a radioiodine test is done, since this will clarify more than half the tests with negative results.
作者测定了998例患者的T3、T4、T7、T3放射免疫分析及基础促甲状腺激素(TSH)的值,以及静脉注射促甲状腺激素释放激素(TRH)后的TSH刺激情况。259例患者(26%)的检测结果为阴性;其中51例患者(5.1%)未发现临床或实验室方面的原因(低反应者或无反应者)。在这组患者中,口服剂量增大100倍重复进行TRH检测;在27例(54%)低反应者或无反应者中,口服检测结果为阳性。总体而言,TRH检测阳性率为76.8%,阴性率为20.9%,无反应者占2.3%。得出的结论是,口服检测比静脉检测提供的信息更多。由于静脉检测仅在5.1%的甲状腺功能正常患者中结果不佳,额外的努力似乎不太值得。此外,静脉TRH检测结果为阴性时,在进行放射性碘检测之前,应先口服重复进行TRH检测,因为这样可以使一半以上结果为阴性的检测得到明确。