Thyrotropin-releasing hormone stimulation test

The thyroid stimulating hormone releasing hormone stimulation test is based on the principle that intravenous TRH is used, and the TSH level of normal people is higher than that before injection, and the TSH secretion reaction is inhibited or the reaction is decreased. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Tips: Pay attention to the normal diet before the examination, pay attention to normal work and rest, and prevent endocrine disorders. Normal value The level of TSH in normal people is 3 to 5 times higher than that before injection, and the peak occurs in 30 minutes and lasts for 2-3 hours. Clinical significance Abnormal results: 1. High metabolic symptoms are often afraid of heat, sweating, weight loss, palpitations, chest tightness, and symptoms are not relieved at rest. And the appetite is too strong. Warm and moist skin, sharp weight loss, low fever (high fever in crisis), etc. TH promotes intestinal sugar absorption, accelerates sugar oxidation, utilization and glycogen decomposition, can cause abnormal glucose tolerance or aggravate diabetes; protein metabolism Accelerated negative nitrogen balance, weight loss; accelerated bone metabolism and collagen renewal, increased urinary calcium, phosphorus, hydroxyproline and other emissions. 2. The goiter is diffusely symmetric and swollen, soft and moves up and down when swallowing. In a small number of patients, the thyroid enlargement is not asymmetrical or swollen. Due to the increased blood flow of the thyroid gland, vascular murmurs (continuous or systolic-like hair-like murmurs) can be heard on the outside of the upper and lower leaves, and tremor can be touched (the upper part of the gland is more obvious). 3. Eye performance is roughly divided into two types. One type is non-invasive eye disease, mainly caused by sympathetic nerve excitatory extraocular muscles and upper diaphragm muscle; the other type is invasive eye disease, which is characterized by increased volume of intra-orbital and post-balloon tissue, lymphocytic infiltration, edema and protrusion. eye. 4. Patients with mental nervous system are irritated, mentally allergic, with fine tremors when the tongue or hands are lifted forward, accompanied by hyperactivity, insomnia, lack of concentration, anxiety, suspicion, and so on. Sometimes there are hallucinations, even sub-mania; but there are also people who are ignorant and depressed, and more common in the elderly. The 腱 reflection is active and the reflection recovery time is shortened. 5. Cardiovascular system Hyperthyroidism manifests as arrhythmia, heart enlargement and heart failure. More common in elderly hyperthyroidism and long-term failure to control well. Cardiac hypertrophy leads to high cardiac output heart disease in the long-term effects of excess TH. 6. The digestive system is mostly characterized by anorexia, a few anorexia, and even cachexia. Due to the effect of too much TH, intestinal peristalsis increases, stools are sparse, the number of times increases, and even intractable diarrhea. A small number of abnormal liver function, elevated transaminase or even jaundice may occur. 7. The total number of white blood cells around the blood system is low, the percentage and absolute value of lymphocytes and mononuclear cells increase, and sometimes purpura can occur. Malnutrition and iron utilization disorders can cause anemia. 8. The motor system is mainly characterized by weak muscles and weakness with bone density (BMD). 9. Female patients with reproductive system often have rare menstruation, prolonged cycles, and even amenorrhea. Men can have impotence and occasionally mammary gland development. 10. The skin, hair and extremities show smooth and delicate skin, lack of wrinkles, warm and moist touch, and flushing of the face. Some patients may have erythematous changes on the face and neck, and the touch fades, especially in men. Some patients have hypopigmentation, vitiligo, hair loss or alopecia areata. The skin is thick and thick, and then it is flaky or nodular, and finally bark-like, which can be associated with secondary infection and pigmentation. A small number of soft tissues can be seen in the soft tissue of the fingertips, which are sputum-like, with new bone formation under the periosteum of the metacarpophalangeal (soap bubble), and the separation of the adjacent free edge of the finger or toenail and the nail bed, called the thick end of the finger, also known as GD. One of the characteristic performances. 11. The early symptoms of hyperthyroidism are characterized by exacerbation of the original symptoms, moderate fever, weight loss, nausea, vomiting, fever up to 40 ° C or higher, heart rate often above 160 beats / min, with sweating, abdominal pain , diarrhea, even convulsions, coma. 12. Hyperthyroidism Acute myopathy is onset, and dysphagia can occur within a few weeks. The pronunciation is not accurate, and it can also be combined with hyperthyroidism and can lead to respiratory muscle spasm. Chronic myopathy starts slowly, mainly involving the proximal muscles and shoulder or hip muscles, followed by the distal muscles; patients complain of progressive muscle weakness, even muscle atrophy. The above-mentioned symptoms of hypermetabolism, goiter, and exophthalmos, etc., which are suspected of hyperthyroidism, are related to the symptoms. Low results may be diseases: hypothyroid cardiomyopathy, hyperthyroidism in the elderly, nodular goiter, prolactinoma precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. Inspection process method: TRH400~g was injected intravenously, and blood was collected before injection and at 15, 30, 60, 90, and 120 minutes after injection to determine serum TSH. Judging: The level of TSH in normal people is 3 to 5 times higher than that before injection, and the peak occurs in 30 minutes and lasts for 2-3 hours. In hyperthyroidism, serum T3 and T4 concentrations increased, and feedback inhibited the release of pituitary TSH, so TSH secretion was inhibited or decreased after injection of TRH. Not suitable for the crowd Inappropriate crowd: temporarily unknown. Adverse reactions and risks No related complications and hazards.

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