Bouchard C, Allard P, Mercier P, St-Laurent M, Dussault J, Puymirat J
Centre Hospitalier Universitaire de Québec, Sainte-Foy, Canada.
Ann Endocrinol (Paris). 1997;58(2):152-7.
The aim of this study was to measure the prevalence of hypothyroidism in 239 elderly patients and to determine the validity of TSH assay on blood dried on filter paper (spot-test) for the diagnosis of hypothyroidism. The sensitivity and specificity of the spot-test were evaluated in a subgroup of 177 subjects. The prevalence of hypothyroidism was 14.2% (34/239). The spot-test did not give satisfactory results for the diagnosis of hypothyroidism in elderly subjects. Due to the lack of specificity, most of the positive results were false positives and the clinician had to rely on laboratory determination of plasma TSH level to confirm hypothyroidism in half of the patients. We do not recommend the spot-test for the diagnosis of hypothyroidism in the elderly. Laboratory assay of plasma TSH is required for confirming hypothyroidism in the elderly.
本研究的目的是测定239例老年患者甲状腺功能减退症的患病率，并确定滤纸干血斑促甲状腺激素检测（斑点试验）用于诊断甲状腺功能减退症的有效性。在177名受试者的亚组中评估了斑点试验的敏感性和特异性。甲状腺功能减退症的患病率为14.2%（34/239）。斑点试验在老年受试者甲状腺功能减退症诊断中未给出满意结果。由于缺乏特异性，大多数阳性结果为假阳性，半数患者的临床医生不得不依靠血浆促甲状腺激素水平的实验室测定来确诊甲状腺功能减退症。我们不推荐斑点试验用于老年甲状腺功能减退症的诊断。老年甲状腺功能减退症的确诊需要进行血浆促甲状腺激素的实验室检测。
