Mankikar G D, Clark A N
J Am Geriatr Soc. 1981 Jul;29(7):331-3. doi: 10.1111/j.1532-5415.1981.tb01276.x.
A survey was made of thyroid function tests on 1,153 patients screened for thyroid disease during a two-year period in a Geriatric Department; 13 percent of the test results fell outside the normal range. Of 88 patients who showed above-normal results, only 12 presented with clinical features of thyrotoxicosis. In 37 patients, the biochemical findings indicated euthyroid "thyroxine toxicosis"; high values were found for serum thyroxine (T4) and the free thyroxine index (FT4I) but there were no clinical signs or symptoms of thyrotoxicosis; the values reverted to normal within one to three weeks. This pattern was seen also in 7 examples of T4-treated hypothyroidism. (Overall, the test findings indicated 61 cases of hypothyroidism.) The significance of this transient increase in T4 and FT4I values is discussed. The false positive results suggest that, when laboratory findings are not compatible with the clinical signs, the thyroid function tests should be repeated after another two weeks.
在老年科对1153名接受甲状腺疾病筛查的患者进行了为期两年的甲状腺功能测试调查；13%的测试结果超出正常范围。在88名测试结果高于正常的患者中，只有12名表现出甲状腺毒症的临床特征。在37名患者中，生化检查结果显示甲状腺功能正常的“甲状腺素中毒”；血清甲状腺素（T4）和游离甲状腺素指数（FT4I）值较高，但无甲状腺毒症的临床体征或症状；这些值在1至3周内恢复正常。在7例接受T4治疗的甲状腺功能减退症患者中也观察到这种模式。（总体而言，测试结果表明有61例甲状腺功能减退症。）本文讨论了T4和FT4I值这种短暂升高的意义。假阳性结果表明，当实验室检查结果与临床体征不符时，应在两周后重复进行甲状腺功能测试。
