甲状腺機能亢進症の薬物療法におけるTRH試験についての研究とくに予後判定指標としての意義について

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In order to evaluate the significance of the TRH (Thyrotoropin Releasing Hormone) test as a guide to the prognosis of hyperthyroidism treated with anti-thyroid agents, 18 subjects who had been treated with MMI (1-methyl-2-mercaptoimidasole) or pm propylthiouracil) for at least one year were examined for the TRH test prior to the termination of treatment. The observation for the prognosis after the termination of medication was followed up for periods ranging from 6 to 22 months (mean : 14.6 months). In the TRH test when the basal TSH value revealed less than 5.2 μU/ml and the peak value revealed more than 7.5μU/ml following the injection of TRH, it was defined as a positive response and in the same manner, when the peak value was below 7.5 μU/ml it was defined as a negative response. Six out of 18 subjects showed relapse or recurrence of hyperthyroidism within a period of 1 to 4 months after termination of medication. Five out of 6 patients suffering recurrence showed a negative response, while one case showed a positive response to TRH. Ten out of 12 subjects without recurrence, on the other hand, showed a positive response, while 2 cases showed a negative response to TRH. A statistical difference in two groups between positive and negative response to TRH was observed. The 2 groups (with and without recurrence) showed no difference with regard to the duration of therapy, type of antithyroid agents and presence or abscence of exophthalmos. Further more, a small dose of TRH (100 μg) was appropriate to determine the normalization of the feed-back mechanism of the pituitary-thyroid system. As a result of the present study, it was shown that a relatively small dose of TRH (100 μg) test in an applicable guide to determine the prognosis of hyperthyroidism with anti-thyroid agents prior to the termination of its treatment.
日本内分泌学会の論文

甲状腺機能亢進症の薬物療法におけるTRH試験についての研究とくに予後判定指標としての意義について

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