Graves病治疗后敏感TSH基础值与TRH兴奋值的关系

RELATIONSHIP OF BASAL SENSITIVE TSH AND ITS RESPONSE TO TRH TEST IN TREATED PATIENTS WITH GRAVES DISEASE

目的 :探讨简化TRH兴奋试验及敏感TSH基础测定取代TRH兴奋试验作为Graves病停药指标的可行性。方法 :比较敏感TSH基础值 (bTSH)与TRH兴奋后各时间点TSH值以及反应值 (△TSH)之间的相关性。结果 :bTSH与 30min ,6 0min和 90minTSH值均明显相关 (均P <0 .0 0 1) ,与△TSH亦显著相关 (P <0 .0 0 1)。以bTSH反映△TSH敏感性为 77.2 % ,特异性为 85 .0 %。结论 :TRH兴奋试验时 90min这一次抽血已无必要 ;但 6 0min的点尚不可以随便省略 ;bTSH尚不可以取代TRH试验作为Graves病的停药指标。

Objective:To investigate the possibility of basal sensitive thyrotropin (bTSH) replacing TRH test to be a marker withdrawig antithyroid drugs in Graves disease. Method:Sensitive bTSH and the response to TRH (△TSH) were measured by immunoradiometric assay in 80 treated patients with Graves disease and the relationship were analyzed.Results:△ TSH were significantly correlated with bTSH ( P <0.001).If the lower limitation of bTSH was definated as x-2s in normal person,the specificity of bTSH predicting △TSH was 85.0%. Conclusion:bTSH can not replace TRH test being a marker withdrawing antithyroid drugs.