Schrub J C, Nouel J P, Brunelle P, Segond G, Courtois H, Poirier A
Nouv Presse Med. 1976 May 22;5(21):1346-8.
Biological abnormalities, in particular increased T3 and sometimes TSH, are frequently found in thyrotoxic patients treated with radioactive iodine and subsequently enthyroid. A high T3, associated with an increase in FT4 and a low TSH precedes a relapse. An increase in TSH may indicate progression towards hypothyroidism; even if FT4 and T3 levels are within normal limits. Caution must be exercised before affirming that an increased TSH with a high T3 and normal FT4 is indicative of thyroid equilibrium. At all events, the risk of hypothyroidism despite the use of small doses of radioactive iodine is such that the classical limit for the treatment of patients with thyrotoxicosis should be increased beyond the age of 40. In patients with a high TSH despite being clinically euthyroid, the use of thyroid extract in low dosage (50 mg/day) would appear to be desirable in avoiding the subsequent development of hypothyroidism.
在接受放射性碘治疗并随后出现甲状腺功能减退的甲状腺毒症患者中,经常发现生物学异常,特别是T3升高,有时TSH也升高。T3升高,伴有FT4升高和TSH降低,预示着复发。TSH升高可能表明向甲状腺功能减退发展,即使FT4和T3水平在正常范围内。在确定TSH升高、T3升高且FT4正常表示甲状腺功能平衡之前,必须谨慎。无论如何,尽管使用小剂量放射性碘仍有甲状腺功能减退的风险,以至于对于甲状腺毒症患者的治疗,40岁以上患者的经典剂量限制应提高。对于临床甲状腺功能正常但TSH升高的患者,使用低剂量(50毫克/天)的甲状腺提取物似乎有助于避免随后出现甲状腺功能减退。