摘要
非甲狀腺疾病症候群(non-thyroidal illness syndrome，NTIS)患者之內分泌檢驗數據，依病情嚴重程度而有多樣的變化。初期表現爲血中三碘甲狀腺素濃度偏低，逆三碘甲狀腺素濃度偏高，疾病的持續進一步使血中甲狀腺素濃度下降，疾病嚴重時游離四碘甲狀腺素與甲狀腺促素濃度亦會降低。作用機轉包括周邊相關激素的代謝異常、血液中結合蛋白質濃度的改變、球蛋白與激素結合力下降、下視丘與腦垂體功能失調，以及藥物對腦垂體分泌甲狀腺促素的干擾。病患的甲狀腺功能是否正常，以及是否需要補充激素仍有許多爭議。本文綜述正反雙方不同之意見，並突顯此醫療困境。
並列摘要
Many non-thyroidal disorders accompanied by abnormality of thyroid function tests defined as non-thyroidal illness syndrome (NTIS) are characterized by decreasing for serum triiodothyronine (T3), increasing for serum reverse T3, and, in the most severe pattern, dropping for serum thyroxine. Though thyrotropin usually remains normal, hormone changes in NTIS representing ”physiologic” or ”pathologic” hypothyroid state is still controversial. Our article tried to discuss the issue whether correcting NTIS with thyroid hormones is beneficial. In addition, we may suggest that prospective, randomized, placebo-controlled studies enrolling a large number of patientsmay provide more evidence in the future.
延伸閱讀
- 白蕙菁、龔信宗（2013）。亞臨床甲狀腺疾病。內科學誌，24(6)，469-476。https://doi.org/10.6314/JIMT.2013.24(6).05
- 張天鈞（2006）。甲狀腺眼病變的治療。當代醫學，(396)，809-811。https://doi.org/10.29941/MT.200610.0007
- 蘇益仁、黃妙珠（1975）。甲狀腺機能亢進症之治療。當代醫學，(16)，49-54。https://doi.org/10.29941/MT.197502.0011
- 宣立人、沈德昌、黃漢文、鄭啟源（1985）。非甲狀腺疾病甲狀腺功能之變化。Journal of Medical Sciences，5(5)，2103-2107。https://www.airitilibrary.com/Article/Detail?DocID=10114564-198503-201404230008-201404230008-2103-2107
- 梁怡鈴、莊明哲、洪晧彰、歐弘毅、吳達仁（2010）。Subclinical Hypothyroidism。內科學誌，21(1)，1-5。https://doi.org/10.6314/JIMT.2010.21(1).01