Goulis D G, Tsimpiris N, Delaroudis S, Maltas B, Tzoiti M, Dagilas A, Avramides A
Section of Endocrinology and Metabolic Medicine, Imperial College School of Medicine, St. Mary's Hospital, London, United Kingdom.
Thyroid. 1998 Jul;8(7):583-7. doi: 10.1089/thy.1998.8.583.
There is only limited evidence for biological parameter abnormalities in subclinical hypothyroidism. The aim of this study was to investigate the impact of varying degrees of thyroid failure on the stapedial reflex as a biological index, and establish its role in the evaluation of the hypothyroid patient. We studied 10 patients with subclinical hypothyroidism, 10 patients with clinical hypothyroidism, and 20 controls. All three parameters of stapedial reflex (amplitude, decay, and threshold) were measured before and after restoration of euthyroidism through thyroxine administration. Data are given as mean +/- SEM. Stapedial reflex maximal amplitudes were different among the groups studied (p < 0.0001), as values in subclinical (4.3 +/- 0.4 mm) and clinical (3.7 +/- 0.3 mm) groups before treatment were lower (p < 0.05) than those of control (5.7 +/- 0.3 mm), and subclinical (6.4 +/- 0.5 mm) and clinical (5.6 +/- 0.4 mm) groups after treatment. Similarly, stapedial reflex decays were different among the groups studied (p < 0.001), as values in subclinical (81 +/- 7 ms) and clinical (89 +/- 4 ms) groups before treatment were higher (p < 0.05) than those in control (65 +/- 2 ms), subclinical (56 +/- 8 ms), and clinical (61 +/- 8 mm) groups after treatment. There was no significant difference among the groups for stapedial reflex threshold or significant correlation between stapedial reflex parameters and thyroid function tests. Stapedial reflex, a biological parameter that reflects neuromuscular status, is abnormal in patients with subclinical and clinical hypothyroidism and returns to normal when clinical and biochemical euthyroidism has been achieved through thyroxine administration.
亚临床甲状腺功能减退症中生物参数异常的证据有限。本研究的目的是调查不同程度的甲状腺功能减退对镫骨肌反射这一生物学指标的影响，并确定其在甲状腺功能减退患者评估中的作用。我们研究了10例亚临床甲状腺功能减退患者、10例临床甲状腺功能减退患者和20例对照者。通过给予甲状腺素使甲状腺功能恢复正常前后，测量镫骨肌反射的所有三个参数（幅度、衰减和阈值）。数据以平均值±标准误表示。所研究的各组之间镫骨肌反射最大幅度不同（p<0.0001），因为治疗前亚临床组（4.3±0.4mm）和临床组（3.7±0.3mm）的值低于对照组（5.7±0.3mm）（p<0.05），且低于治疗后亚临床组（6.4±0.5mm）和临床组（5.6±0.4mm）。同样，所研究的各组之间镫骨肌反射衰减不同（p<0.001），因为治疗前亚临床组（81±7ms）和临床组（89±4ms）的值高于对照组（65±2ms）、治疗后亚临床组（56±8ms）和临床组（61±8mm）。各组之间镫骨肌反射阈值无显著差异，镫骨肌反射参数与甲状腺功能检查之间也无显著相关性。镫骨肌反射是反映神经肌肉状态的生物学参数，在亚临床和临床甲状腺功能减退患者中异常，通过给予甲状腺素实现临床和生化甲状腺功能正常后恢复正常。
