血清游离甲状腺激素放射免疫测定的临床诊断价值

Clinical Significance of Serum free Thyroid Hormones (FT_3、FT_4) Determined by Radioimmunoassay

放免法测定60名正常人、113例甲亢及35例甲减患者的血清FT3,FT4。其测定值在正常人、甲亢及甲减组分别为3.86±0.97,12.16±3.02;18 41±11.07,40.53±18.14;2.53±1.51,4.09±2.15pg/ml。组间差异极其显著(P<0.001)。与其他指标(FT_4I,T_3,T_4,rT_3,TSH)指标比较,FT_3是反映甲亢,FT_4是反映甲减最灵敏的指标,具有早期诊断价值。FT_4反映甲亢仅次于FT_3,FT_3反映甲减则很差。甲减时TSH的诊断符合率仅低于FT_4,故作者认为,联合测定FT_3,FT_4是诊断甲亢,联合测定FT4,TSH是诊断甲减的最佳选择。

Serum free thyroid hormmones (FT_3, FT_4) were determined by radioimmunoassey in 60 normal subjects,113 cases with hyperthroidism and 35 cases with hypothyroidsm. FT_3and FT_4were compared with the FT_4I, T_3, T_4, rT_3, TSH. The FT_3, FT_4values of control, hyperthroidism and hypothyroidism group were 3.86± 0.96, 12.16± 3.02; 18.41 ± 11.07, 40.53 ± 18.14; 2.53± 1.51, 4.09± 2.15 (pg/ml) respectively. All mean values between hyper-hypothyroidism and control group were found significantly different (P<0.01-0.001). Determination of FT_3was the most sensitive and reliable index for hyperthyroidism. FT_4was the most sensitive and reliable index fo hypothyroidism, and even subclinical type. FT_4test for hyperthyroidism was the second sensitive while FT_3for hypothyroidism was not sensitive. From these results, we concluded that FT_3plus FT_4was the best selection for diagnosing hyperthyroidism and FT_4plus TSH was the best for hypothyroidism.