Reevaluation of the thyroidal radioactive iodine uptake test, with special reference to reversible primary hypothyroidism with elevated thyroid radioiodine uptake.
Reevaluation of the thyroidal radioactive iodine uptake test, with special reference to reversible primary hypothyroidism with elevated thyroid radioiodine uptake.
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重新评估甲状腺放射性碘摄取试验，特别注意甲状腺放射性碘摄取升高的可逆性原发性甲状腺功能减退症。
DOI：
10.1210/jcem-67-4-720
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发表时间：
1988
影响因子：
5.8
通讯作者：
M. Fujishima
中科院分区：
文献类型：
--
作者：
K. Okamura;K. Sato;H. Ikenoue;M. Yoshinari;M. Nakagawa;T. Kuroda;M. Fujishima
甲状腺放射性碘摄取（RAIU）试验的临床意义在各种甲状腺疾病的患者进行了重新评估。与262例正常人或194例TSH正常的甲状腺功能正常的弥漫性甲状腺肿患者比较，100例原发性甲状腺功能减退症患者（血清TSH 5-40 mU/L）的RAIU值明显增高。在126例显性原发性甲状腺功能减退症患者（血清TSH，大于40 mU/L）中，RAIU值要么极高（49例可逆性甲状腺功能减退症患者和10例产后甲状腺功能减退症患者），要么极低（67例不可逆性甲状腺功能减退症患者）。潜伏性或可逆性显性甲减患者RAIU值的增加具有TSH依赖性，RAIU值与血清TSH水平之间具有良好的相关性（r = 0.6203; P <0.001）。在显性原发性甲状腺功能减退症中，仅限碘期间，RAIU值高于35%的53例患者中有52例发生甲状腺功能自发恢复，RAIU值在10- 35%之间的23例患者中仅7例发生甲状腺功能自发恢复，RAIU低于10%的50例患者中无一例发生甲状腺功能自发恢复。因此，通过高RAIU值预测恢复（P <0.001;预测率，91.4%）。可逆性甲减患者甲状腺肿大率约为80%，而不可逆性甲减患者甲状腺肿大率仅为34%。碘限制期间甲状腺功能恢复也发生在71%的潜伏性甲状腺功能减退症患者中。然而，RAIU测量并不能预测潜伏性甲状腺功能减退症患者的预后。我们的结论是碘诱导的可逆性甲状腺功能减退症在我们的患者人群中很常见，RAIU测量可能有助于确定显性原发性甲状腺功能减退症患者的预后。
The clinical significance of the thyroidal radioactive iodine uptake (RAIU) test was reevaluated in patients with various thyroid disorders. Compared with 262 normal subjects or 194 patients with euthyroid diffuse goiter with normal serum TSH levels, RAIU values were significantly higher in 100 patients with latent primary hypothyroidism (serum TSH, 5-40 mU/L). In 126 patients with overt primary hypothyroidism (serum TSH, greater than 40 mU/L), RAIU values were either extremely high (49 patients with reversible hypothyroidism and 10 patients with postpartum hypothyroidism) or low (67 patients with irreversible hypothyroidism). The increase in RAIU values in latent, or reversible overt hypothyroidism was TSH dependent, and there was a good correlation between RAIU values and serum TSH levels (r = 0.6203; P less than 0.001). In overt primary hypothyroidism, spontaneous recovery of thyroid function during iodide restriction alone occurred in 52 of 53 patients with RAIU values above 35%, in only 7 of 23 patients with RAIU values between 10-35%, and in none of 50 patients with RAIU below 10%. Thus, recovery was predicted by high RAIU values (P less than 0.001; prediction rate, 91.4%). Goiter was found in about 80% of the patients with reversible hypothyroidism, compared with only 34% of the patients with irreversible hypothyroidism. Recovery of thyroid function during iodide restriction also occurred in 71% of the patients with latent hypothyroidism. However, RAIU measurements did not predict the prognosis of patients with latent hypothyroidism. We conclude that iodine-induced reversible hypothyroidism is common in our patient population, and RAIU measurements may be helpful in determining the prognosis of patients with overt primary hypothyroidism.