第一线FT4和TSH在查中央甲状腺功能低下症中的当前实用性
Carol Evans1, Jiya Jacob2, Annabel Rodham1
1Department of Medical Biochemistry, Immunology and Toxicology, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK.
Clinical endocrinology
|May 2, 2024
概括
一线甲状腺刺激激素 (TSH) 和自由T4 (FT4) 测试是常见的,但中央甲状腺功能低下症很少见. 在当前实践中,低FT4水平对这种情况的预测值很低.
科学领域:
- 内分泌学 在内分泌学.
- 临床化学 临床化学
- 诊断测试 诊断测试 诊断测试
背景情况:
- 甲状腺检测策略在实验室之间有所不同.
- 结合甲状腺刺激激素 (TSH) 和自由T4 (FT4) 测试是一种常见的第一线方法.
- 这种策略在检测中枢甲状腺功能低下症方面的有用性需要重新评估.
研究的目的:
- 评估一线TSH和FT4测试用于检测中央甲状腺功能低下症的临床实用性.
- 为了确定当前实践中中央甲状腺功能低下症的发病率.
主要方法:
- 来自全威尔士实验室信息系统的甲状腺功能测试的回顾性分析.
- 确定患有低FT4和不适当的TSH的患者 (≥16岁).
- 对临床信息的审查,以确定低FT4的原因和诊断中央甲状腺功能低下症.
主要成果:
- 低FT4的发病率因测试方法而异 (98-301例/100,000人口/年).
- 检测到15例中央甲状腺功能低下的新病例,相当于2例/100,000人口/年.
- 对于中央甲状腺功能低下症,低FT4的积极预测值很低 (2% - 4%).
结论:
- 中枢甲状腺功能低下症是罕见的,尽管常见的低FT4发现.
- 增加甲状腺检测和药物使用降低了低FT4.4的预测值.
- 甲状腺查策略必须平衡测试产量与调查非病理结果的成本.
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