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[甲状腺功能亢进症治疗的控制。体外与体内方法的比较]

[Control of therapy for hyperthyroidism. Comparison of in-vitro and in-vivo methods].

作者信息

Heberling H J, Heilmann W, Gauer J, Müller G, Löbe J, Gottschild D

出版信息

Z Gesamte Inn Med. 1977 Apr 1;32(7):109-11.

PMID:69363
Abstract

55 patients with treated hyperthyroidism (thyreostatics) underwent a T3 suppression test and a TRH stimulation test. 60% of the patients had a positive and 40% a negative T3 suppression test. While patients with a positive T3 suppression test always showed a positive TRH test, the behaviour of the TRH test in negative suppression test was different (68.2% positive, 31.8% negative). These discrepant findings are to be explained from the establishment of different phases of regulation. In negative TRH test the concentrations of hormones were significantly higher. Increased basal TSH values are an expression of an overtreatment with thyreostatics. In positive suppression test and TRH test after a therapy lasting at least one year the medication can be stopped. In negative suppression test, however, the therapy should be changed. The TRH test allows only evidence about the quality of the regulation of therapy. Finally it can be established that the two tests on account of their different working points in the regulatory system are necessary and not changeable between each other.

摘要

55例接受过甲亢治疗(使用抗甲状腺药物)的患者接受了T3抑制试验和促甲状腺激素释放激素(TRH)刺激试验。60%的患者T3抑制试验结果为阳性,40%为阴性。T3抑制试验阳性的患者TRH试验总是呈阳性,而TRH试验在T3抑制试验阴性时的表现有所不同(68.2%为阳性,31.8%为阴性)。这些不一致的结果应从不同调节阶段的建立来解释。TRH试验阴性时激素浓度显著更高。基础促甲状腺激素(TSH)值升高表明抗甲状腺药物治疗过度。在持续至少一年的治疗后的T3抑制试验和TRH试验阳性时,可以停用药物。然而,在T3抑制试验阴性时,应改变治疗方案。TRH试验仅能提供有关治疗调节质量的证据。最后可以确定,由于这两项试验在调节系统中的工作点不同,它们都是必要的,且相互不可替代。

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