80例甲亢手术及其并发症分析

目的探讨甲状腺功能亢进术前准备、术中处理及其与术后并发症发生的关系。方法80例具有手术指征，无禁忌证的甲状腺功能亢进患者，术前给予充分而完善的准备，行甲状腺次全切除术后资料分析。结果80例甲亢患者中术后治愈76例（95．0％），3例复发（3．7％），1例死亡，占1．2％。结论术前充分完善准备，术中轻柔细致操作，合理规范用药，可减少和避免并发症的发生。     

131^I治疗甲亢后早发甲低的临床分析

目的：探讨影响131^I治疗后甲状腺功能低下的因素及治疗措施。方法：对我院1998年1月-2005年12月收治的136例131^I治疗后早发甲低患者疗效进行观察、总结,对早发甲低患者的发生率及影响因素进行分析。结果：101例暂发性甲低患者均未行甲状腺素替代治疗,98例1年内恢复正常,3例在6月后服用左旋甲状腺素片替代治疗。结论：131^I治疗后早发甲低受多种因素的影响,早发甲减的患者以观察为主。     

氧化应激及足细胞损伤在甲状腺功能亢进大鼠肾损害中的作用

目的观察氧化应激、转化生长因子-β1和巢蛋白表达变化在甲状腺功能亢进大鼠肾损害中的作用。方法优甲乐灌胃法制作甲亢大鼠模型，测定25，45，60d大鼠肾组织中抗氧化酶：超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH—Px）、过氧化氢酶（CAT）活性，丙二醛（MDA）含量及TGF—β1、Nestin表达变化。结果随甲亢病程延长，CAT、GSH—Px、SOD活性逐渐降低，MDA含量逐渐增加；TGF—β1表达逐渐增多，而Nestin表达逐渐减少；且TGF—β1及Nestin表达均与氧化应激有相关性。结论氧化应激、TGF-β1表达增加及足细胞损伤相互作用共同参与甲亢肾脏损伤过程。     

甲亢患者心理健康状况的调查分析

目的：调查甲状腺功能亢进症（甲亢）患者的心理健康状况。方法：采用症状自评量表（SCL-90），艾克森个性问卷（EPQ）及生活事件量表（LES），对50例甲亢患者进行测定并与50例正常组对照比较。结果：SCL-90除人际敏感、精神病性因子外，其它因子分显著高于对照组（P〈0．05）。EPQ神经质（N）分显著高于正常对照组（P〈0．01）。LES负性刺激量、总刺激量明显高于对照组（P〈0．05）。结论：甲亢患者具有神经质个性，经历的应激生活事件较多，心理健康状况较差。     

甲状腺机能亢进症糖耐量改变的探讨

对１３２例甲状腺机能亢进症病人进行分析。结果表明：（１）糖耐量减低占１５．２％，糖耐量试验曲线呈糖尿病样改变者占１９．７％。治疗后糖耐量减低组７０％病从于２周左右血糖恢复正常，糖耐量曲线呈糖尿病样组病人血糖恢复较慢，治疗１个月在右仅１１．５％血糖恢复正常，５７．７％仍呈糖耐量低减状态，３０．８％仍为糖尿病样改变。（２）胰岛素释放试验示耐量曲线呈糖尿病样组病人释放高峰后管，胰岛素敏感性也低于正常对照     

Hyperthyroidism Influences Ultrasound Bone Measurement on the Os Calcis

The objective of our study was to compare bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters in women with hyperthyroidism and controls. In this cross-sectional study, QUS parameters and BMD values observed in untreated hyperthyroid patients were compared with data obtained from age-matched controls. Twenty-four women with Graves' disease were studied. Eight patients were postmenopausal. All patients had evidence of thyrotoxicosis as indicated by a raised total serum thyroxine and a suppressed serum thyroid stimulating hormone. BMD of the hip, lumbar spine and whole body, and body composition, were measured by DXA. Ultrasound evaluation on the os calcis was performed with an Achilles device. All measurements were performed before antithyroid therapy. The QUS parameters of BUA, SOS and Stiffness were significantly lower in hyperthyroid patients than in controls. Similar results were observed for the BMD of lumbar spine, femoral neck and total skeleton. Lean tissue and fat mass were also significantly decreased in hyperthyroid patients. In conclusion, these findings suggest that hyperthyroidism affects cortical and trabecular bone equally, as well as bone quality. QUS measurements may be helpful for assessing, using a simple and non-irradiating method, the bone effects of thyrotoxicosis. Received: 9 June 1997 / Accepted: 27 October 1997     

Hyperthyroidism as a cause of persistent choreic movements

A patient is described who had thyrotoxicosis more than 30 years ago and suffers since that time from persistent choreic movements. This case suggests for the first time that chorea induced by hyperthyroidism may outlast the endocrine disorder and become irreversible.     

定量骨超声对诊断甲状腺功能亢进症患者骨代谢异常的意义

目的探讨定量骨超声在甲状腺功能亢进症(甲亢)骨代谢异常中的意义。方法选择118例甲亢患者,用Sunlight-Ominisense超声骨强度仪检测其桡骨、胫骨超声波传导速度(SOS),双能X线骨密度仪测定其腰椎、股骨近端骨密度。用放射免疫方法测定血清总甲状腺素(TT4),总三碘甲状腺原氨酸(TT3),游离甲状腺素(FT4),游离三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)的水平。血生化的方法测定血碱性磷酸酶。结果与正常对照比较,甲亢患者胫骨和桡骨SOS降低(40~50岁:3809±171vs.3955±102,3881±713vs.4187±114;50~60岁:3721±223vs.3852±102,3875±201vs.4035±114),差异均有统计学意义(均P<0·05);SOS与骨密度呈显著性正相关(P<0·05);甲亢胫骨和桡骨SOS异常的发生率(Z值≥-1的发生率分别为41·2%、43·3%,-2·5相似文献   

Results of Surgery for Toxic Multinodular Goiter

Purpose We analyzed the clinical and histological features of patients operated on for toxic multinodular goiter (TMG) to determine the clinical profile and evaluate the surgical results. Methods We reviewed 672 patients who underwent surgery for multinodular goiter (MG), 112 (17%) of whom had hyperthyroidism, and analyzed the epidemiological, clinical, and surgical variables. Results The patients with TMG tended to be older than those with nontoxic MG, with a greater evolution time of the goiter and a higher rate of positive antithyroid antibodies. In the multivariate analysis, the only feature characteristic of TMG, as opposed to nontoxic MG, was the evolution time. Morbidity was 34%, representative of the fact that that most of the patients were seen before the establishment of our endocrine surgical unit. The hyperthyroid symptoms resolved in all patients, but 4 of 17 patients who underwent partial surgical resection showed signs of relapse within a follow-up period of 98 ± 71 months. Conclusions TMG is characterized by a long evolution time and is most effectively treated by total thyroidectomy, which achieves complete remission from symptoms, without relapse, and is necessary if there is associated carcinoma. However, the incidence of complications may be high if this procedure is not carried out by surgeons with experience in endocrine surgery.     

A rare case of Graves’ disease during regular hemodialysis

We report a case of Graves disease in a patient on regular hemodialysis. The patient also suffered from Wolff-Parkinson-White (WPW) syndrome and paroxysmal atrial fibrillation, which may both have been manifestations of the Graves disease because of the increased oxygen demand. To our knowledge, this is the first case to illustrate the usefulness of the antithyroid agent propylthiouracil for Graves disease complicated by endstage renal disease (ESRD) and WPW syndrome.