Rondanini G F, Focarile F, Bollati A, Bianchi C
Pediatr Med Chir. 1983 Nov-Dec;5(6):473-6.
L-tiroxine (L-T4) substitutive therapy has been evaluated in a group of 15 hypothyroid children (6 males and 9 females), one to six years old. We have found a wide dosage range, being not possible to find any significant difference between ranges leading to normal and ranges leading to pathological findings, thus making impossible to suggest a reasonably safe dosage pro kg. of body weight. Increasing L-T4 dosage we have got a significant increase of FT4 levels, a significant decrease of TSH levels, but no variations of FT3 values, indicating an individual capability in regulating FT3 disposal. FT3 and TSH are the most valuable indexes of therapy adequacy, since their normality reflects an euthyroid status; we should achieve an individually adequate dose of L-T4, based on clinical judgment and hormonal findings.
对一组15名年龄在1至6岁的甲状腺功能减退儿童(6名男性和9名女性)进行了左甲状腺素(L-T4)替代疗法评估。我们发现剂量范围很广,导致正常结果的剂量范围与导致病理结果的剂量范围之间未发现任何显著差异,因此无法给出合理安全的每千克体重用药剂量。增加L-T4剂量后,游离甲状腺素(FT4)水平显著升高,促甲状腺激素(TSH)水平显著降低,但游离三碘甲状腺原氨酸(FT3)值无变化,这表明个体对FT3代谢的调节能力。FT3和TSH是治疗是否充分的最有价值指标,因为它们的正常反映了甲状腺功能正常状态;我们应根据临床判断和激素检查结果,确定个体适用的L-T4剂量。