De Whalley P
Br J Gen Pract. 1995 Feb;45(391):93-5.
Hypothyroidism is a common disorder, easily treated with thyroxine therapy. Thyroid stimulating hormone level assay can detect under- or overtreatment.
A study was carried out in one general practice to discover the number of people on thyroxine therapy, their care, and whether abnormal thyroid stimulating hormone level values resulted in alterations to their thyroxine dose.
The study was undertaken in a north Suffolk general practice of 7640 patients. A computer search identified patients receiving repeat prescriptions for thyroxine therapy and their notes were studied. A thyroid stimulating hormone level value in the range of 0.3-3.8 mU l-1 was considered to indicate an appropriate thyroxine dose.
Thyroxine was being taken by 162 patients (2%), of whom 146 were women. Thyroid stimulating hormone level had been checked within the last year for 127 patients (78%). At their last thyroid stimulating hormone level test, 48 patients (30%) had a value above the normal range, only 21 of whom (44%) had their thyroxine dose increased as a result. The thyroid stimulating hormone level was below 0.3 mU l-1 at the last check in 38 patients (23%), only four of whom (11%) had their thyroxine dose reduced as a result.
There is often failure to adjust thyroxine dose despite abnormal thyroid stimulating hormone levels. However, more research is needed to determine the ideal thyroid stimulating hormone levels which should be aimed for in these patients, and whether tight control of thyroxine dosage is able to reduce morbidity and mortality among patients with hypothyroidism.
甲状腺功能减退是一种常见疾病，通过甲状腺素治疗易于控制。促甲状腺激素水平检测可发现治疗不足或过度治疗的情况。
在一家普通诊所开展一项研究，以了解接受甲状腺素治疗的患者人数、他们的治疗情况，以及促甲状腺激素水平异常是否会导致甲状腺素剂量的调整。
该研究在萨福克郡北部一家拥有7640名患者的普通诊所进行。通过计算机检索确定接受甲状腺素重复处方治疗的患者，并研究他们的病历。促甲状腺激素水平值在0.3 - 3.8 mU l-1范围内被认为表明甲状腺素剂量合适。
162名患者（2%）正在服用甲状腺素，其中146名是女性。在过去一年中，127名患者（78%）的促甲状腺激素水平已被检查。在他们最后一次促甲状腺激素水平检测时，48名患者（30%）的值高于正常范围，其中只有21名（44%）患者因此增加了甲状腺素剂量。在最后一次检查时，38名患者（23%）的促甲状腺激素水平低于0.3 mU l-1，其中只有4名（11%）患者因此减少了甲状腺素剂量。
尽管促甲状腺激素水平异常，但甲状腺素剂量通常未能得到调整。然而，需要更多研究来确定这些患者应达到的理想促甲状腺激素水平，以及严格控制甲状腺素剂量是否能够降低甲状腺功能减退患者的发病率和死亡率。
