口服碘油丸对甲状腺功能和自身抗体的影响

本文对尚未补碘的缺乏病区人群进行了口服碘油丸前后甲状腺功能和自身抗体的研究，结果表明补碘前，甲状腺能处于代偿状态，放射性碘摄取呈典型的碘饥饿改变，甲状腺自身抗体水平正常，未检出抗体阳性者，而补碘后，碘饥饿状态显著改善，病情明显好转，但甲状腺功能仍旧代偿，甲状腺自身抗体水平明显增高，抗体阳性者显著增多，提示服碘油虽可纠正机体缺碘状态，改善甲状腺功能状态，却易使成年人机体产生甲状腺自身抗体，而造成甲状     

甲状腺疾病临床

20 0 2年 9月在瑞典召开的欧洲甲状腺年会上介绍了当前有关甲状腺疾病临床及基础研究的进展 ,现将临床部分的情况摘要介绍给同道。丹麦报告 2个中、轻度碘缺乏地区甲状腺自身抗体的情况 ,应用放射免疫分析 (ＲＩＡ)方法随机测定了 4 6 5 9例 18～ 6 5岁受检者甲状腺过氧化物酶抗体 (ＴＰＯ Ａｂ)和甲状腺球蛋白抗体 (ＴｇＡｂ)阳性率。甲状腺自身抗体 [ＴＰＯＡｂ和 (或 )ＴｇＡｂ]的阳性率是18.8% ,ＴＰＯＡｂ和ＴｇＡｂ两种甲状腺自身抗体阳性率相当 (13.1%∶13% ) ;女性阳性率高并随年龄增大而增加 ,6 0～ 6 5岁阳性率为最高 ,其中两种抗…     

甲状腺特异性抗体

甲状腺特异性抗体刘超，张忠邦甲状腺特异性抗体主要来源于甲状腺内的淋巴细胞，是针对甲状腺激素、甲状腺球蛋白（Ｔｇ）、甲状腺微粒体（Ｔｍ）即甲状腺过氧化物酶（ＴＰＯ）和促甲状腺激素（ＴＳＨ）受体等抗原产生的自身抗体。这些抗体多存在于自身免疫性甲状腺疾病（...     

胺碘酮致老年患者甲状腺功能异常临床病例分析

目的长期服用胺碘酮引起甲状腺功能异常增高,且在不同地区胺碘酮引起甲状腺功能异常的类型差异很大。本文观察广东地区老年心律失常患者长期口服胺碘酮导致甲状腺功能异常的临床特征及转归。方法263例口服胺碘酮老年患者,其中男性184例,女性79例,年龄60~87平均(74.6±11.3)岁。在服药前均经放射免疫法测定血液甲状腺功能,排除了甲状腺功能异常。在服药中和停药后半年多次测定甲状腺功能,并同时测定自身免疫学指标TGA、MCA、TG。结果随访过程中出现甲状腺功能异常的老年患者62例,其中男性45例,女性17例。本组患者中,服用胺碘酮后甲状腺功能异常出现时间最短为3周,最长为2.5年。11例服药后出现甲状腺功能亢进,51例出现甲状腺功能减退,82%的患者在停药3个月后T3、T4、FT3、FT4恢复正常,而只有23%的患者TSH恢复。所有患者服药前、服药中和停药后自身免疫学指标甲状腺球蛋白(TGA)、甲状腺球蛋白抗体(MCA)、甲状腺微粒体抗体(TG)均未发现明显改变。结论在广东地区,胺碘酮引起甲状腺功能异常以甲状腺功能减退为主,临床病程个体差异较大;自身免疫在胺碘酮所致的甲状腺功能异常中不起主要作用;胺碘酮引起的甲状腺功能异常在停药后均可恢复,无需长期治疗。     

补碘对缺碘人群促甲状腺激素受体抗体的影响

为探讨补碘对缺碘机体甲状腺自身免疫的影响，采用酶联免疫分析方法测定了缺碘地区人群口服碘油前后的促甲状腺激素受体抗体(TRAb)和甲状腺刺激抗体(TSAb)水平变化。结果发现，缺碘机体补碘后的TRAb和TSAb水平均明显高于补碘前;TRAb从阳性检出率增高，12个月时其阳性检出率高达24．44％。表明缺碘地区人群补碘后其自身抗体水平增高且抗体阳性率增多。提示补碘可诱导缺碘机体发生甲状腺自身免疫反应，易产生自身免疫性甲状腺疾病。     

补碘对缺碘机体甲状腺自身免疫的影响

目的 探讨补碘对缺碘机体甲状腺自身免疫的影响。方法 动态观察缺碘地区居民口服碘油补碘前后、血清免疫球蛋白（IgA、IgG、IgM）、补体C3、甲状腺过氧化物酶抗体（TPOAb)、甲状腺球蛋白抗体（TGAb)、促甲状腺激素受体抗体（TRAb)和甲状腺刺激抗体（TSAb)水平变化及其异常值检出率。结果 补碘3个月后IgA、IgG、补体C3水平明显高于补碘前的水平，IgG和C3高于正常值上限的比例分别高达38．9％、62．0％，6个月时IgA和IgG水平则明显下降。补碘之后的TPOAb、TGAb水平及其阳性检率均明显高于补碘前，且以3个月和6个月时增高较为显著并分别在79和64例受试者中出现7例双抗体阳性病例；这些抗体阳性者全为成年女性，平均年龄27．6岁，均无明显临床症状。TRAb和TSAb水平也均明显高于补碘前，12个月时TRAb的阳性检出率高达24.4%。结论 补碘可诱发缺碘机体免疫反应使免疫功能增强，存在产生自身抗体的倾向，导致甲状腺自身抗体水平明显升高、抗体阳性检出率增加，而易于产生亚临床性自身免疫性甲状腺疾病。     

桥本甲状腺炎患者甲状腺与外周血中单个核细胞免疫功能比较

目的 研究桥本甲状腺炎（ＨＴ）患者甲瘃腺内单个核细胞（ＴＭＧ）和外周血中单个核细胞（ＰＢＭＣ）产生自身抗体和白细胞介素－１（ＩＬ－１）、ＴＮＦα的能力。方法 甲瘃腺球蛋白抗体（ＴｇＡｂ）和抗甲状腺过氧化物酶抗体（ＴＰＯＡｂ）采用放射免疫测定法,ＩＬ－１和ＴＮＦα采用生物学测定法。结果 （１）ＨＴ鹗２ＴＭＣ和ＰＢＭＣ均能产生ＴｇＡｂ,但ＴＭＣ能力强于ＰＭＢＣ（Ｐ〈０．０１）,ＴＭＣ能产生Ｔ：ＰＯＡｂ     

010 血清甲状腺球蛋白和甲状腺球蛋白自身抗体分析方法初探

０１０血清甲状腺球蛋白和甲状腺球蛋白自身抗体分析方法初探［英］／ＭａｒｉｏｔｔｉＳ…／／ＪＣｌｉｎＥｎｄｏｃｒｉｎｏｌＭｅｔａｂ，－１９９５．８０（２），４６８～４７２甲状腺球蛋白自身抗体（ＴｇＡｂ）的存在对血清甲状腺球蛋白（Ｔｇ）测定分析有很大的干...     

自身免疫性甲状腺疾病细胞学变化与自身抗体及临床转归…

采用ＦＮＡＢ方法检查１１５例自身免疫性甲状腺疾病（ＡＩＴＤ）患者，治疗前分别按甲状腺内淋巴细胞浸润程度和腺上皮细胞变异程度进行分组，观察血清自身抗体ＴＭＡ、ＴＧＡ水平与ＴＲＡｂ、ＴＳＡｂ阳性率，及其与细胞学异常变化的关系，并随访停药后甲状腺细胞学情况，观察与疾病复发的关系。结果表明，血清ＴＭＡ、ＴＧＡ与淋巴细胞浸润程度关系密切，ＴＲＡｂ、ＴＳＡｂ阳性率与腺上皮细胞变异程度有明显相关性。并且，停药后     

Graves病患者血清TSAb,TBⅡ和TGI的联合检测及临床价值

同时检测Ｇｒａｖｅｓ病（ＧＤ）患者血清甲状腺刺激抗体（ＴＳＡｂ）、甲状腺生长免疫球蛋白（ＴＧＩ）和ＴＳＨ结合抑制免疫球蛋白（ＴＢＩＩ），并对部分病例停药后随访半年。结果显示：（１）ＧＤ未治组ＴＳＡｂ、ＴＢＩＩ和ＴＧＩ的活性与阳性率均显著高于ＧＤ缓解组和停药组，后两组差异无显著性，但其抗体的活性与阳性率仍高于正常对照组。（２）三种自身抗体的活性与血清甲状腺激素水平无显著相关性，但ＴＧＩ与甲状腺肿大程     

Thyroid hormone and immunological studies in endemic goiter

Iodized oil (1 ml im) was given to 58 goitrous patients from a mildly iodine-deficient area in Greece. Goiter size, urinary iodine, and serum T4, T3RU, T3, rT3, TSH, thyroxine-binding globulin (TBG), and thyroid autoantibodies were measured before and 1, 3, and 6 months after the injection. Goiter size decreased. Serum T4 remained relatively constant, but TBG decreased and therefore T3RU and FTI increased. Serum T3 and rT3 initially decreased (P less than 0.001) and then increased at the sixth month (P less than 0.001), both showing roughly parallel changes. Serum TSH, initially normal (1.42 +/- 0.11 (SEM) mU/liter), decreased to 0.65 +/- 0.01 and 0.76 +/- 0.05 mU/liter at the third and sixth month (difference from baseline P less than 0.001). Thyroid autoantibodies, both against thyroglobulin and the microsomal antigen, were undetectable before treatment, but became positive in 42.8% of the patients 3 and 6 months later. Three patients developed transient hyperthyroidism. This occurred 3 or 6 months after treatment, and was associated with high titers of thyroid autoantibodies. These results indicate that: 1) transient hyperthyroidism may occur after the administration of iodized oil, possibly because of thyroid tissue necrosis and leakage of hormones, and 2) serum TBG decreases after iodized oil, a finding not previously reported and one whose cause is not known.     

碘油和碘盐对碘缺乏病区孕妇碘代谢影响的动态研究

观察了长期供应１／４万－１／２万碘盐的ＩＤＤ病区妊娠妇女在孕前服与未服碘油丸对纠正体内碘代谢动态变化的影响。发现服碘油的孕妇血清ＴＳＨ，Ｔｇ值在孕３，５个月时降低，然后升高，Ｔ４，ＦＴ４升高持续到怀孕７个月，Ｔ３与ＦＴ３在３，５个月时恒定在孕前水平，然后下降，ｒＴ３在孕５个月时明显升高，提示碘油仅能保护孕妇在妊娠期的前５个月不缺碘，在此时应再服一次小剂量碘油丸。     

Side-effects of iodized oil administration in patients with simple goiter

The objective of this study was to determine side-effects associated with iodized oil injection in patients with simple goiter. In an iodine-deficient population, 3420 patients with simple goiter, who were not taking supplemental iodine, were chosen for this study. They received a single intramuscular injection of 1 ml iodized oil, containing 480 mg iodide. Clinical and laboratory evaluations were performed every 3 months for one year and every 6 months for the next 4 years. The incidence of hypo- and hyperthyroidism was 0.6% each, with equal prevalence in both sexes. Most cases of hypo- and hyperthyroidism were observed during the first 5 months after the injection. Eight cases of hyperthyroidism were asymptomatic. A further 8 patients had overt thyrotoxicosis and required treatment with methimazole for 18 months. Recurrence of hyperthyroidism was observed in one patient. Five hypothyroid patients were diagnosed only by abnormal thyroid function tests, and 4 cases needed no treatment. Others received T4 treatment for a mean of 14.5 months. Among 14 T4-treated patients, recurrence of hypothyroidism occurred in 7 patients after treatment was discontinued. Twenty-nine patients (0.8%) were afflicted with dermatologic complications. The most common dermatologic side-effect was urticarial reaction. In 15 subjects, skin lesions appeared 8 to 14 days after injection. It is concluded that side-effects of iodized oil injection are rare, and in most cases the complications are transient and self-limited. The occurrence of iodine induced hyperthyroidism following iodized oil administration is close to the ratio observed in spontaneous thyrotoxicosis.     

Iodized oil treatment for endemic goiter does not induce the surge of positive serum concentrations of anti-thyroglobulin or anti-microsomal autoantibodies

Forty-three goitrous patients (grade II and III, WHO classification), living in areas of chronic iodine deficiency, were treated with an injection of iodized oil (470 mg iodine). Serial measurements of serum thyroid hormone levels after the therapy revealed increasing concentrations of both hormones, with a significantly lower serum T3/T4 ratio, and progressively significantly lower serum TSH mean values. Serum Tg mean value, initially elevated (58 +/- 9 ng/ml), decreased after 6 months and returned to the normal range at 36 months of therapy. In none of the examined patients (except for one subject with positive autoantibodies before therapy), it was observed the surge of positive anti-thyroglobulin or anti-microsomal autoantibodies after the iodized oil. We conclude that iodized oil therapy does not induce an abnormal autoimmune reaction in endemic goiter patients.     

The effectiveness of oral iodized oil in the treatment and prophylaxis of endemic goiter

In a longitudinal study carried out for 2 yr in the Darfur region, western Sudan, 2316 school children received a single dose of 2 capsules of iodized oil (400 mg iodine) orally, and 1161 school children received 1 ml of the same preparation im (475 mg iodine); 2393 school children served as controls. One year after treatment, goiter prevalence was reduced from 67.0% to 36.0% among the children who had received oral iodized oil and from 71.0% to 42.0% in those who received it im. The prevalence in the control group did not change. The prevalences in each group were approximately the same 2 yr after treatment. Urinary iodine excretion increased after treatment and remained significantly higher than the initial value during the trial. In subjects from rural Darfur, serum T4 levels were increased 1 yr after treatment with oral iodized oil (P less than 0.001) and im iodized oil (P less than 0.01), and remained high in the former (P less than 0.05) but not in the latter. This increase was accompanied by reduction of serum T3 and TSH levels. Sialadenitis occurred in 3.7% of the children who received oral iodized oil. Thyroid antibodies were not detected before treatment, but microsomal antibodies were detected in 2 of the 128 subjects studied who received iodized oil orally. Comparable results occurred when oral and im iodized oil were given to 841 individuals covering a wider age range. It is concluded that a single oral dose of iodized oil is effective in the correction of iodine deficiency, reducing the goiter size and preventing the recurrence of goiter for at least 2 yr.     

Treatment of iodine deficiency in school-age children increases insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations and improves somatic growth

CONTEXT: Iodine deficiency in utero impairs fetal growth, but the relationship between iodine deficiency and postnatal growth is less clear. OBJECTIVE: The objective of the study was to determine whether iodine repletion improves somatic growth in iodine-deficient children and investigate the role of IGF-I and IGF binding protein (IGFBP)-3 in this effect. DESIGN, PARTICIPANTS, AND INTERVENTIONS: Three prospective, double-blind intervention studies were done: 1) in a 10-month study, severely iodine-deficient, 7- to 10-yr-old Moroccan children (n = 71) were provided iodized salt and compared with children not using iodized salt; 2) in a 6-month study, moderately iodine-deficient, 10- to 12-yr-old Albanian children (n = 310) were given 400 mg iodine as oral iodized oil or placebo; 3) in a 6-month study, mildly iodine-deficient 5- to 14-yr-old South African children (n = 188) were given two doses of 200 mg iodine as oral iodized oil or placebo. At baseline and follow-up, height, weight, urinary iodine (UI), total T4 (TT4), TSH, and IGF-I were measured; in Albania and South Africa, IGFBP-3 was also measured. RESULTS: In all three studies, iodine treatment increased median UI to more than 100 microg/liter, whereas median UI in the controls remained unchanged. In South Africa, iodine repletion modestly increased IGF-I but did not have a significant effect on IGFBP-3, TT4, or growth. In Albania and Morocco, iodine repletion significantly increased TT4, IGF-I, IGFBP-3, weight-for-age z scores, and height-for-age z scores. CONCLUSION: This is the first controlled study to clearly demonstrate that iodine repletion in school-age children increases IGF-I and IGFBP-3 concentrations and improves somatic growth.     

The effect of iodine administration on the development of thyroid autoimmunity in patients with nontoxic goiter.

OBJECTIVE: Previous studies, mostly performed in iodine-deficient areas, have suggested that the administration of iodine to patients with endemic goiter may be associated with the development of thyroid autoantibodies (ThAbs); however, this has not been a consistent finding. In this study, we evaluated the effect of iodine on thyroid function and on the development of indices of autoimmunity (ThAbs and lymphocytic infiltration) in an iodine replete area. METHODS: Iodized oil (1 mL) was administered intramuscularly to 40 euthyroid patients with nontoxic goiter, adequate iodine intake, and absent or normal levels of ThAbs. Blood and urinary samples were taken at time 0, 3, 6, and 12 months after iodine administration. Thyroid volume was evaluated and fine-needle aspiration (FNA) was performed at 0, 6, and 12 months. RESULTS: Seven patients developed abnormal levels of ThAbs at some time between 3 and 12 months after iodine administration (p = 0.017). Mean anti-thyroglobulin (Tg) antibody levels increased at 6 months without reaching abnormal levels, but did not reach statistical significance (p = 0.062). Lymphocytic infiltration was detected in FNA smears in 10 cases before and in 27 cases after treatment (p = 0.0003). Triiodothyronine (T3) decreased at 12 months of follow-up, while thyroxine (T4) and thyrotropin (TSH) levels did not change significantly. A decrease in the mean levels of thyroglobulin as well as a small reduction in goiter size was observed at 6 and 12 months. CONCLUSION: The administration of iodized oil to patients with small nontoxic goiter in an iodine-replete area was accompanied by the development of abnormal levels of ThAbs in some cases and by an increase in thyroid lymphocytic infiltration.     

The effect of thyroxine, 3, 5-dimethyl-3'isopropyl-L-thyronine and iodized oil on fetal brain development in the iodine-deficient sheep

Studies have been carried out to investigate the role of maternal and fetal thyroid function in the effects of iodine deficiency on fetal brain development in sheep. Iodine deficiency was established with an especially prepared low-iodine diet of maize and pea pollard. The iodine-deficient sheep were mated and the end of the second trimester of pregnancy (100 days gestation) were divided into groups which received either a sc injection of T4 or 3,5-dimethyl-3-isopropyl-L-thyromine or an injection of iodized oil. AT 140 days gestation (10 days prior to parturition) comparison of the fetuses delivered by hysterotomy revealed that the retarded fetal brain development observed in iodine deficiency was greatly improved by T4 and by iodized oil. However, T4 and iodized oil failed to correct the reduction in the number and the increase in the length of synaptic appositions which were observed in the fetal cerebral cortex after iodine deficiency. In addition, the histological appearance of the fetal thyroid gland and the levels of plasma thyroid hormones were restored to normal. The administration of 3,5-dimethyl-3'-isopropyl-L-thyronine had no effect on the retarded fetal brain and body development of the iodine-deficient fetuses. The lack of response may be due to the ability of 3,5-dimethyl-3'-isopropyl-L-thyronine to cross the ovine placenta as no reduction in the abnormally elevated fetal plasma TSH observed in spite of a fall in maternal plasma TSH and apparent restoration of maternal thyroid function.(ABSTRACT TRUNCATED AT 250 WORDS)     

碘缺乏病病区单纯食用合格碘盐的孕妇碘营养状况调查

目的 了解碘缺乏病病区妊娠妇女单纯依靠碘盐能否满足这一特殊人群生理过程的需要。方法采用称重法进行为期4d的膳食调查,同时收集4d的尿样,测定尿碘含量。结果 孕妇从盐中摄取的碘量达到了每日推荐的供给量标准（RDA）,同时尿碘水平表明孕妇的碘营养状况良好。结论 孕妇单纯依靠食用碘盐做为碘的来源能满足各孕期的生理需求。