Lundström B, Gilliquist J, Kågedal B, Tegler L
Acta Chir Scand. 1976;142(7):495-9.
193 patients operated on for hyperthyroidism were examined at follow up a mean 4.5 years after operation (range 1-6 years). The patients were examined clinically and biochemically. It was found that 4.6% had a permanent paralysis of the recurrent nerve and 2.6% a permanent hypoparathyroidism. Recurrent hyperthyroidism was found in 2.6%. The patients were grouped according to the results of basal S-TSH and the TRH-stimulation test. Within the groups it was found that all patients with a normal basal TSH were clinically euthyroid. 35 patients had a raised basal TSH or a hypothyroid pattern in the TRH-test, or both. Among these, 14 clinically hypothyroid patients were found. The remaining 21 patients were euthyroid clinically and were classified as subclinically hypothyroid. The levels of basal TSH were significantly higher in subclinically hypothyroid patients than in euthyroid patients and still higher in clinically hypothyroid patients. The response to TRH stimulation was also higher in the hypothyroid patients than in the subclinically hypothyroid patients. It was also found that the proportion of clinically hypothyroid patients was significantly higher, after 5 years than after one year. Since it cannot be decided if the patients with a subclinical hypothyroidism are at risk for manifest disease a close follow up of these patients is recommended.
对193例接受甲亢手术的患者进行了随访检查，术后平均随访4.5年（范围1 - 6年）。对患者进行了临床和生化检查。结果发现，4.6%的患者出现喉返神经永久性麻痹，2.6%的患者出现永久性甲状旁腺功能减退。复发性甲亢的发生率为2.6%。根据基础促甲状腺激素（S-TSH）结果和促甲状腺激素释放激素（TRH）刺激试验对患者进行分组。在各亚组中发现，所有基础TSH正常的患者临床甲状腺功能均正常。35例患者基础TSH升高或在TRH试验中呈甲状腺功能减退模式，或两者皆有。其中，发现14例临床甲状腺功能减退患者。其余21例患者临床甲状腺功能正常，被归类为亚临床甲状腺功能减退。亚临床甲状腺功能减退患者的基础TSH水平显著高于甲状腺功能正常的患者，临床甲状腺功能减退患者的基础TSH水平更高。甲状腺功能减退患者对TRH刺激的反应也高于亚临床甲状腺功能减退患者。还发现，临床甲状腺功能减退患者的比例在5年后显著高于1年后。由于无法确定亚临床甲状腺功能减退患者是否有发生明显疾病的风险，建议对这些患者进行密切随访。
