亚临床甲状腺功能减退患者的甲状腺自身抗体及对促甲状腺激素释放激素的反应
Thyroid antoantibodies and the response to thyrotropin releasing hormone in patients with subclinical hypothyroidism.
作者信息
Mojiminiyi O A, Rege V, Bolodeoku J, Wilcox A H, Barron J L
机构信息
Department of Chemical Pathology and Metabolism, St Helier Hospital, Carshalton, Surrey.
出版信息
J Clin Pathol. 1995 May;48(5):463-5. doi: 10.1136/jcp.48.5.463.
AIM
To evaluate the clinical usefulness of the thyrotropin releasing hormone (TRH) test and estimation of thyroid autoantibody concentrations in patients with borderline raised thyroid stimulating hormone (TSH).
METHODS
The records of 34 consecutive patients with persistent borderline increased TSH (4.4-9.9 mU/l) referred to the Medical Investigation Unit were reviewed. The response of patients with thyroid autoantibodies to the TRH test was compared with that of patients with a negative antibody screen.
RESULTS
Eleven (44%) of 25 patients with positive anti-thyroid microsomal and/or thyroglobulin antibody tests and three (33%) of nine patients with a negative antibody screen had hypothyroid responses to TRH. Neither age nor sex affected the response to TRH. Basal TSH alone was poorly correlated with these indices. Twelve (35%) patients who had elevated basal TSH had a normal response to the TRH test.
CONCLUSION
Patients with positive or negative thyroid autoantibodies and an exaggerated response to the TRH test should be regarded as hypothyroid and treated with thyroxine. Patients with positive thyroid autoantibodies and normal TSH response may subsequently develop hypothyroidism and should be given long term follow up.
目的
评估促甲状腺激素释放激素（TRH）试验及甲状腺自身抗体浓度测定在促甲状腺激素（TSH）临界升高患者中的临床应用价值。
方法
回顾了连续转诊至医学检查科的34例TSH持续临界升高（4.4 - 9.9 mU/l）患者的病历。将甲状腺自身抗体阳性患者对TRH试验的反应与抗体筛查阴性患者的反应进行比较。
结果
25例抗甲状腺微粒体和/或甲状腺球蛋白抗体试验阳性患者中有11例（44%），9例抗体筛查阴性患者中有3例（33%）对TRH试验呈甲状腺功能减退反应。年龄和性别均不影响对TRH的反应。仅基础TSH与这些指标的相关性较差。12例（35%）基础TSH升高的患者对TRH试验反应正常。
结论
甲状腺自身抗体阳性或阴性且对TRH试验反应过度的患者应被视为甲状腺功能减退并给予甲状腺素治疗。甲状腺自身抗体阳性且TSH反应正常的患者随后可能发展为甲状腺功能减退，应给予长期随访。
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