The initial stage of hyperthyroidism is mainly diagnosed by measuring total blood T3(TT3), total blood T4(TT4), free blood T3(FT3), free blood T4(FT4) and hypersensitivity TSH. When the clinical symptoms are mild, T3 usually rises first, and then T4, showing typical clinical symptoms. When the symptoms are not completely controlled in the treatment of hyperthyroidism, only T3 can be seen to increase, which is of great significance for the early diagnosis and recurrence of hyperthyroidism.
(1) The normal value of TT4 in blood is 54- 167pmol/L, and the normal value of FT4 is10-30 pmol/L. TT4 and FT4 increase in hyperthyroidism.
(2) The normal value of blood TT3 is 0.8-2.6pmol/L, and the normal value of FT3 is 3.5- 10pmol/LFT3, which is more important in the diagnosis of hyperthyroidism. In the early stage of hyperthyroidism, only FT3 is often increased.
(3) The decrease of TSH in hyperthyroidism can be measured by ultra-sensitive TSH kit to 0.02mU/L, and the diagnosis of hyperthyroidism can be made by persistently low TSH.
(4) The normal value of basal metabolic rate (BMR) is 65438 0.5%, which is significant for children over 5 years old, especially for hyperthyroidism. + 15%。 Due to the popularity of thyroid function measurement, basal metabolic rate has been rarely measured.
(5) In the TRH excitation test, TSH was measured at 65438 05, 30, 90 and 65438 020 minutes before and after injection, respectively. TSH increased by 5-40mU/L in normal 30 min, and T3 was inhibited too much in hyperthyroidism, but TSH secretion did not increase or was lower than normal.
(6) Determination of anti-thyroglobulin antibody (TGAb) and anti-thyroid microsomal antibody (TMAb) to determine whether Hashimoto's disease causes hyperthyroidism. All kinds of excitatory or inhibitory thyroid antibodies were measured to observe the therapeutic effect and the possibility of recurrence.
2, other auxiliary inspection
(1) thyroid scan, to understand the size and nodular nature of thyroid, except for tumors and cysts.
(2) Thyroid ultrasound can show the size of thyroid gland, showing nodules and cysts.