甲状腺素治疗新生儿硬肿症疗效观察

目的 观察甲状腺素治疗新生儿硬肿症的疗效。方法 将63例随机分为甲状腺素治疗组(简称治疗组)32例,对照组31例,两组均给予综合治疗,治疗组加用甲状腺素片每天4～6mg/kg口服,疗程1周。结果 治疗组与对照组总有效率分别为87.5％、61.3％,有显著差异(P<0.05)。两组间复温时间分别为7.0±3.7h、16.5±11.2h,硬肿消退时间分别为4.1±1.9天、6.9±3.1天,住院时间分别为6.9±3.1天、9.8±4.6天,治疗组比对照组明显缩短,有显著差异(P<0.01)。结论 新生儿硬肿症使用甲状腺素治疗可明显提高治愈率,缩短病程,且使用方便,无副作用。     

不同分级肝硬化患者血清甲状腺素水平的意义

目的探讨肝硬化患者血清中甲状腺素水平的变化与肝硬化病变程度及其临床实验室检查之间的相关性。方法用放免法测定肝硬化患者血清FT3、FT4、PC-Ⅲ、Ⅳ-C、LN及HA，并按Child—Pugh方法将肝功能分为A、B、C三级。结果随着肝硬化病变程度的加重，血清肝纤维化指标逐渐增高，甲状腺素呈下降趋势，同时血清甲状腺素水平与肝硬化的低蛋白血症、腹水及凝血酶原时间密切相关。结论肝硬化患者体内存在不同程度的甲状腺素水平紊乱，紊乱程度与肝功能受损程度有明显相关性，联合检测血清FT3、FT4、PC-Ⅲ、Ⅳ—C、LN及HA对估计肝硬化病变程度及判断预后有十分重要的临床价值。     

心血管疾病血清甲状腺激素测定的临床意义

本文用放射免疫分析(RIA)法,对348例心血管疾病患者及40例正常者进行了血清三碘甲状腺原氨酸(T_3)、甲状腺素(T_4)、游离甲状腺激素(FT_3、FT_4)及促甲状腺众素(TSH)测定。结果心血管疾病患者出现血清T_3、FT_3值下降,部分伴有T_4值下降,FT_4及TSH值正常,表明甲状腺激素浓度可因所患非甲状腺疾病发生改变。     

甲状腺机能亢进症辨证分型与甲皱微循环及TT_3、TT_4、FT_4I和吸~(131)碘率的关系

对甲状腺机能亢进症(甲亢)患者进行了临床辨证分型,同步观察甲皱微循环及检测TT_3 TT_4 FT_4I、吸~(131)碘率,探讨它们之间的关系。结果表明甲亢患者微循环积分明显高于对照组(P<0.01),但不同类型甲亢的血淤情况亦不相同。心肝火旺型的微循环积分低于气滞痰凝型和血瘀型,但TT_3、TT_4、FT_4I明显增高;气滞痰凝型居中;血淤型的微循环积分明显增高,但TT_3、TT_4、FT_4I低于其他两型。吸~(131)碘率三型间无差异(P>0.05)。     

The effects of aging on the circadian rhythm of serum cortisol in the dog

The purpose of this study was to determine if aging affects the circadian rhythm of serum cortisol. Female beagle dogs belonging to three age groups were used: adult (3.3 ± 0.6 (SD) years), old (12.1 ± 0.3 years), and puppies (8.4 ± 0.2 weeks). Blood samples were collected by cephalic or jugular venipuncture at 3-h intervals during three 24-h periods and analyzed for total serum cortisol concentrations by radioimmunoassay. The circadian rhythm was present in the serum cortisol of adult animals, but no significant changes during a 24-h period could be detected in the old animals. No circadian rhythm in serum cortisol was present in the puppies. It is concluded that the circadian rhythm in plasma cortisol is disrupted in old animals and is not yet developed in puppies.     

Use of a sensitive enzyme immunoassay for human thyrotropin in the diagnosis of hyperthyroidism

A sensitive, simultaneous sandwich enzyme immunoassay for TSH was evaluated especially for its ability to distinguish hyperthyroid patients from the euthyroid population. A total of 140 patient samples was analzyed by this assay as well as with a two-step sandwich radioimmunoassay. The diagnostic sensitivity of the thyrotropin assay was 92.5% and the specificity was 88%. False negatives by thyrotropin assay included two patients with Graves' disease who were being treated with propranolol at the time of testing and one patient who was considered hyperthyroid while receiving synthroid. Twelve patients with elevated free thyroxine index levels were considered euthyroid and 50% of these had thyrotropin values that were undetectable; most were elderly patients with nonthyroidal illnesses. Although the thyrotropin enzyme immunoassay had good sensitivity and precision for the detection of hyperthyroidism, our data suggest the limitation of a single thyrotropin determination in establishing the euthyroid state, especially in elderly patients with associated nonthyroidal illnesses and hyperthyroxinemia.     

An enzyme-linked immunosorbent assay for thyroxine in dried blood spotted on filter paper

We have developed a rapid and sensitive enzyme-linked immunosorbent assay (ELISA) for thyroxine (T4) in dried blood samples spotted on filter paper. The assay is carried out on microtiter plates without extraction or centrifugation steps. The detection limit of the assay is 5 pg/disc/well, equivalent to 1.25 micrograms/1 of whole blood or 2.5 micrograms/1 of serum. Intra- and inter-assay coefficients of variation for various T4 concentrations are 2.4-9.0% and 5.9-17.5% respectively. Correlation between the proposed ELISA method and the RIA is good (r = 0.900, n = 62, y(RIA) = 0.99x(ELISA) + 9.90). The ELISA method is useful for mass-screening of neonatal congenital hypothyroidism using dried blood samples on filter paper, is very simple and one person can assay more than 300 samples per day.     

Effects of thyroxine and temperature manipulations upon the hatching of chick embryos (Gallus domesticus)

Thyroxine levels within chick embryos (Gallus domesticus) and incubation temperature were manipulated late in development in order to determine those events most proximal to the time of hatching that are both necessary and sufficient for the appearance of the hatched state. Events recorded include the time of breathing initiation, changes in breathing rate, time of puncture of the chorioallantoic membrane and changes in rate of loss of yolk sac material. It was found that a certain level of thyroxine is necessary for an animal to hatch, that breathing and puncture of the chorioallantoic membrane are necessary but not sufficient to predict the occurrence of hatching, and that a change in rate of loss of yolk sac material during the last 18 hr prior to hatching is sufficient to predict the occurrence of hatching. The explanatory hypothesis offered is that the endogenous increase in thyroxine levels acting via increased metabolic rates is necessary and sufficient for the animals to hatch.     

Use of a single thyroxine test to evaluate ambulatory medical patients for suspected hypothyroidism

Previous recommendations for the use of thyroid function tests to diagnose patients with possible hypothyroidism have discounted the value of a total thyroxine (T₄) test because many clinically hypothyroid patients have T₄ levels that fall within the “normal” range. The authors examined the predictive value of a total T₄ measurement in the evaluation of ambulatory general medical patients suspected of having hypothyroidism. Pregnant patients and those who were taking medications that interfere with thyroid homeostasis were excluded. Simultaneous T₄ and thyrotropin (TSH) tests of 93 consecutive outpatients suspected to have hypothyroidism but found to be euthyroid and 27 patients discovered to be hypothyroid (TSH>10 μU/ml) were examined. A T₄ of 7.0 μl/dl or less had a sensitivity of 93% with a false-positive rate of 19%. A T₄ greater than 8.0 μg/dl appeared to exclude hypothyroidism (negative posttest probability of 100%). It may be possible to achieve cost savings without loss of diagnostic accuracy by using a single total T₄ measurement for the initial evaluation of suspected hypothyroidism in selected outpatients. Received from the Department of Medicine, General Medicine Unit. University of Rochester School of Medicine and Dentistry, Rochester, New York.     

血清FT3、FT4联合放免检测法的建立

目的研究一种可以联合检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)的固相放射免疫分析(放免)(Radioimmunoassay RIA)方法.方法用葡萄球菌蛋白A(SPA)分别制备T3抗体包被管和T4抗体包被珠,在同一体系中与各自抗原作用,最后管、珠分别进行放射性测定,建立联合RIA,并与独立检测的液相RIA试剂盒对照.结果FT3、FT4最小检测值分别为0.34 pmol/L、0.76 pmol/L;回收率均值为99.6%和98.2%;变异系数符合RIA要求;与对照试剂盒检测48份血清,结果进行t检验t=-0.918,P＞0.2及t--0.897,P＞0.2.结论本方法比传统方法简单,所得结果无统计学差异,具有应用价值.