Total and free thyroid hormone concentrations in patients receiving maintenance replacement treatment with thyroxine.
Total and free thyroid hormone concentrations in patients receiving maintenance replacement treatment with thyroxine.
复制标题
接受甲状腺素维持替代治疗的患者的总甲状腺激素和游离甲状腺激素浓度。
作者：
C. J. Pearce;R. Himsworth
对122例临床症状良好的甲状腺功能减退症患者在接受常规甲状腺激素替代治疗的同时，测定了血清总甲状腺素和三碘甲腺原氨酸的浓度。在三分之一的患者中，总的和游离的甲状腺激素浓度升高，通常是相当大的；然而，总的和游离的三碘甲腺原氨酸的浓度通常是正常的。虽然总三碘甲腺原氨酸浓度与总甲状腺激素浓度之间有显著的相关性(p<0.001)，三碘甲腺原氨酸浓度与游离甲状腺激素浓度之间也有显著的相关性(p<0.001)，但描述这些相关性的回归方程的斜率很小，因此总和游离三碘甲状腺原氨酸浓度的大幅增加伴随着总三碘甲腺原氨酸浓度和游离三碘甲状腺原氨酸浓度的轻微增加。因此，服用甲状腺素的患者体内总的或游离的甲状腺激素浓度高于正常水平并不一定会造成临床后果。在评估甲状腺激素替代治疗的充分性时，体外甲状腺功能测试结果最合理的组合可能是正常的促甲状腺激素浓度和正常的游离三碘甲腺原氨酸浓度。
Total and free serum concentrations of thyroxine and triiodothyronine were measured in 122 subjects with hypothyroidism who were clinically well while receiving conventional replacement treatment with thyroxine. In a third of patients concentrations of total and free thyroxine were raised, often considerably; nevertheless concentrations of total and free triiodothyronine were usually normal. Though significant correlations were obtained between total triiodothyronine concentrations and total thyroxine concentrations (p less than 0.001) and between the triiodothyronine concentrations and free thyroxine concentrations (p less than 0.001) the slope of the line of the regression equation describing these correlations was small, hence large increases in both total and free thyroxine concentrations were accompanied by only modest increases in total and free triiodothyronine concentrations. The presence of total or free thyroxine concentrations above normal in patients taking thyroxine therefore are not necessarily of clinical consequence. In the assessment of adequacy of replacement treatment with thyroxine the most logical combination of in vitro thyroid function test results may be a normal thyrotrophin concentration and normal free triiodothyronine concentration.