高敏甲状腺功能试验——血β-TSH、FT_4、FT_3联合检验的临床意义

The Climcal Value of Highly Sensitive Thyroid Function Test with Serum β-TSH,FT_4,FT_3 Combined Measurement

报告了458例血β-TSH、FT_4、FT_3放射免疫学检测结果,并对其临床意义进行了分析研究.β-TSH、FT_4、FT_3均可用于甲状腺疾病的诊断、鉴别诊断和治疗随访.甲亢时β-TSH减低,FT_4、FT_3增高,甲低时则相反,且均随病情好转而回复正常,病情控制不良可维持原状态,投药过量则引起药物性甲低或甲亢.单纯性甲肿时β-TSH、FT_4、FT_3基本无变化.妊娠后β-TSH、FT_4如常,FT_3降低.非甲病时β-TSH、FT_4、FT_3一般无变化,但存在低FT_3或/和FT_4血症,及高FT_4或/和FT_3血症.β-TSH、FT_4、FT_3联检能更好地反应腺垂体-甲状腺轴功能,并可相互佐证,提高准确性和及时发现其分离现象.试剂盒的国产化使其在我国广泛应用创造了条件。

Serum beta-thyrotropin (β-TSH), free thyroxine(FT_4) and free triiodothyronine (FT_3) levels were de- termined with Radioimmunology test in 458 cases and it clinical value, were also analysed. β-TSH,FT_4 and FT_3 can be useed as the diagnosis, differential diagnosis and treatement follow-up of thyroid disease. The β- TSH levels decreased while FT_4,FT_3 value increased in hyperthyroidism. The results was opposite to it in hypothyroidism. These values returned to normal when the patient's condition became well. If these diseases were not controlled, these values would remain the same level. Overdosing of drug could induce bypo-or hy- perthyroidism. In simple goiter, the levels of β-TSH, FT_4, FT_3 remain no change. In pregnancy, the β-TSH and FT_4 are as usual but FT_3 is lower. In non-thyroid illness, these values usually do not change, but low level of FT_3 or/and FT_4 syndrome and high level of FT_4 or/and FT_3 syndrome exist. Combined determination of the β-TSH, FT_4, FT_3 produced better result in testing the gland pituitary-thyroid axis function, which could give mutual proof and increase accuracy, and discove the dissociation phenomena without delay. The Chinese-made reagent kits have created favourable conditions for their qeneral and wide use in China.