促甲状腺素释放素兴奋试验评价已治甲亢患者甲状腺功能

Assessment of Thyroid Function by Thyrotropin-Releasing Hormone Stimulation in Treated Patients with Hyperthyroidism

作者观察44例甲亢患者治疗后静注TRH前后血清TSH,T_3,T_4,FT_4I的变化及其相互关系。亚临床及临床甲低组在静注TRH后30 min,TSH平均增量分别为31.91和49.50 mU/L显著高于甲功正常组(其平均△TSH为6.32mU/L),90minTSH明显下降,其平均值分别为18.51和43.90mU/L,但仍显著高于本组基础值(分别为4.2 5fH20.56mU/L)。两组的基础T_4和FT_4I与TSH值均呈显著负相关,FT_4I与静注TRH后TSH增量也相关显著。

In order to detect hypothyroidism from treated patients with hyperthyroi-dism much earlier, serum thyroid hormone and TSH. concentrations and their interrelations were determind before and after intravenous injection of 300 μg of TRH in 44 treated patients with hyperthyroidism that included 22 patients with euthyroid and 9 patients with subclinical hypothyroidism and 13 patients with clinical hypothyroidism. Thirty minutes after TRH stimulation in patients with subclinical and clinical hypothyroidism, the average increases in serum TSH were 31.91 mU/L and 49.50 mU/L, respectively, and significantly different from that of the patients with euthyrcid, then TSH levels decreased 90 min after TRH test, and were 18.31 mU/L and 43.90 mU/L, respectively, bat still remained at a higher level than that in basal condition (4.25 mU/L, 20.58.mU/L, respectively). In 16 patients with subclinical and clinical hypothyroidism, scrum basal levels of T4 and FT4I showed an inverse correlation with serum basal level of TSH and serum basal level of FT4I showed an inverse correlation with the rise of serum TSH level after TRH test.