How to assess functional state of thyroid gland, and what should we do in situation when thyroid function tests are inadequate?

G. Melnichenko, A. Rybakova
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引用次数: 3

Abstract

In most cases, estimation of tests of the functional state of the thyroid gland does not cause difficulties. Often, according to results of hormonal research, we can conclude that there is a manifest (subclinical) hypothyroidism or a manifest (subclinical) hyperthyroidism. In these situations, difficulties in diagnosing and prescribing treatment to the patient usually do not arise. However, in clinical practice, can be a situation when the results of laboratory researches either do not correspond to clinical picture or do not correspond to the normal functioning of the pituitary-thyroid axis by the principle of log negative relationship. In such situations, quite often inadequate results can be explained by laboratory errors, effect of drugs or existence of genetic disease. Also, recently more and more questions arise in the diagnosis of the syndrome of euthyroid pathology. The correct algorithm of action in this situation will play a key role in diagnosing and identification of further tactics of patient management. In this study will be considered factors that lead to changes in laboratory researches and structured approach to assess functional state of the thyroid gland, which has big importance in clinical practice.
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如何评估甲状腺的功能状态,在甲状腺功能检查不充分的情况下,我们应该怎么做?
在大多数情况下,对甲状腺功能状态测试的估计不会造成困难。通常,根据激素研究的结果,我们可以得出明显(亚临床)甲状腺功能减退或明显(亚临床)甲状腺功能亢进的结论。在这些情况下,通常不会出现诊断和处方治疗的困难。但在临床实践中,往往会出现实验室研究结果与临床情况不相符,或按对数负相关原则与垂体-甲状腺轴的正常功能不相符的情况。在这种情况下,往往可以用实验室错误、药物作用或存在遗传疾病来解释不充分的结果。近年来,甲状腺功能正常综合征的诊断也出现了越来越多的问题。在这种情况下,正确的行动算法将对诊断和确定进一步的患者管理策略起关键作用。本研究将考虑导致实验室研究变化的因素和结构化的方法来评估甲状腺功能状态,这在临床实践中具有重要意义。
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