Gordin A, Lamberg B A
Clin Endocrinol (Oxf). 1981 Dec;15(6):537-43. doi: 10.1111/j.1365-2265.1981.tb00699.x.
A follow-up study was performed on subjects with symptomless autoimmune thyroiditis in order to obtain information on the natural course of the disease. Seven out of the twenty-two subjects with symptomless autoimmune thyroiditis became hypothyroid within 4-48 months of observation, whereas fifteen subjects were still euthyroid after an observation period of 26-102 months. The yearly incidence of hypothyroidism in symptomless autoimmune thyroiditis was 7.3%. The basal serum thyrotrophin (TSH) level as well as the response in serum TSH to thyrotropin releasing hormone (TRH) was initially elevated in all subjects who developed hypothyroidism. The annual incidence of hypothyroidism was 26% in the subjects with an initially elevated TSH level. Serum TSH was initially normal in all but one of the eleven subjects with symptomless autoimmune thyroiditis in whom it was measured, and who remained euthyroid. In this group the TRH response was initially slightly exaggerated in three out of ten subjects. It was not performed in five subjects. During the follow-up, serum TSH and its response to TRH also became normal in these cases. An elevated basal serum TSH value is thus highly indicative of subsequent hypothyroidism, and these subjects with symptomless autoimmune thyroiditis should be carefully followed-up.
为了获取无症状自身免疫性甲状腺炎疾病自然进程的信息，对患有该疾病的受试者进行了一项随访研究。在22例无症状自身免疫性甲状腺炎受试者中，有7例在4至48个月的观察期内发展为甲状腺功能减退，而15例在26至102个月的观察期后仍保持甲状腺功能正常。无症状自身免疫性甲状腺炎患者甲状腺功能减退的年发病率为7.3%。所有发生甲状腺功能减退的受试者，其基础血清促甲状腺激素（TSH）水平以及血清TSH对促甲状腺激素释放激素（TRH）的反应最初均升高。TSH水平最初升高的受试者中，甲状腺功能减退的年发病率为26%。在测量的11例无症状自身免疫性甲状腺炎受试者中，除1例甲状腺功能仍正常的受试者外，其余受试者的血清TSH最初均正常。在该组中，10名受试者中有3名的TRH反应最初略有增强。5名受试者未进行该检测。在随访期间，这些受试者的血清TSH及其对TRH的反应也恢复正常。因此，基础血清TSH值升高高度提示随后会发生甲状腺功能减退，这些无症状自身免疫性甲状腺炎患者应进行仔细随访。
