Noelpp B, Staub J J, Heinimann T, Gräni R, Girard J
Schweiz Med Wochenschr. 1981 Dec 5;111(49):1904-5.
Preclinical hypothyroidism (i.e. basal thyroxine within the normal laboratory range, basal TSH normal or elevated and exaggerated TSH response to TRH) is a biochemical constellation of uncertain clinical relevance. The oral TRH test with simultaneous measurements of TSH and thyroid hormones before and 3 h after 40 mg TRH provides information about both pituitary and thyroid reserve. In a group of female patients with preclinical hypothyroidism, basal thyroxine but not triiodothyronine was found to be clearly diminished compared with a group of healthy female controls, indicating a slight thyroid hormone deficiency. Furthermore, a progressively reduced thyroid reserve of T4 and especially of T3 was seen to be closely related to elevation of basal TSH as an expression of thyroid cell insufficiency. These data emphasize the clinical importance of TSH elevation despite normal thyroxine levels as a better individual sign of impending primary hypothyroidism.
临床前甲状腺功能减退症（即基础甲状腺素在实验室正常范围内，基础促甲状腺激素正常或升高，且对促甲状腺激素释放激素的促甲状腺激素反应增强）是一组临床相关性不确定的生化表现。口服促甲状腺激素释放激素试验，在40毫克促甲状腺激素释放激素给药前及给药后3小时同时测量促甲状腺激素和甲状腺激素，可提供有关垂体和甲状腺储备的信息。在一组临床前甲状腺功能减退症的女性患者中，与一组健康女性对照相比，发现基础甲状腺素明显降低，但三碘甲状腺原氨酸未降低，这表明存在轻微的甲状腺激素缺乏。此外，甲状腺素尤其是三碘甲状腺原氨酸储备的逐渐减少与基础促甲状腺激素升高密切相关，这是甲状腺细胞功能不全的一种表现。这些数据强调了尽管甲状腺素水平正常，但促甲状腺激素升高作为即将发生原发性甲状腺功能减退症的更好个体指标的临床重要性。
