免费三甲状腺素检测的有限实用性
Yanchun Lin1, Amy E Riek2, Ann M Gronowski1
1Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States.
The journal of applied laboratory medicine
|July 20, 2023
概括
自由三甲状腺素 (fT3) 测试对于诊断T3甲状腺毒性最有用,当甲状腺刺激激素 (TSH) 被抑制,自由甲状腺素 (fT4) 是正常或低时. 一个TSH切线<0.01μIU/mL优化FT3测试,特别是在门诊环境.
科学领域:
- 内分泌学 在内分泌学.
- 临床化学 临床化学
- 甲状腺学 甲状腺学
背景情况:
- 当甲状腺刺激激素 (TSH) 被抑制,自由甲状腺素 (fT4) 正常或降低时,自由三甲状腺素 (fT3) 测试是合适的,这种情况被称为T3甲状腺毒性病.
- 缺乏FT3反射测试的既定指南,需要对其临床有用性进行评估.
研究的目的:
- 为了确定FT3测试的临床实用性.
- 为了确定正常或降低fT4水平的患者fT3反射测试的最佳TSH切割值.
主要方法:
- 从2016年1月到2021年10月,对TSH,FT4和FT3实验室结果进行了回顾性分析.
- 在各种 TSH 切线处评估生化T3 甲状腺毒性病的发生频率.
- 在门诊患者和住院患者之间比较T3甲状腺毒性病的患病率.
主要成果:
- 在4366个TSH-fT4-fT3结果中的1.6%中确定了生化T3甲状腺毒素.
- 在较低的TSH切断值 (<0.01μIU/mL显示27.6%的检测率) 的情况下,T3甲状腺毒性病的检测率显著增加.
- 新诊断的甲状腺功能障碍症仅在TSH<0.01μIU/mL的患者中观察到. 在TSH<0.01μIU/mL时,T3毒毒症在门诊患者 (34%) 比在住院患者 (14%) 更频繁.
结论:
- T3甲状腺毒毒症是一种罕见的诊断,fT3测量在大多数患者中具有有限的效用.
- 在TSH<0.01 μIU/mL和正常/低fT4的患者中实施ft3反射测试可以提高临床效用.
- 这种方法可以减少不必要的ft3测试,特别是在门诊环境中.
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