甲状腺素片联合左甲状腺素钠片治疗甲减的疗效观察

目的探究甲减患者采用甲状腺素片联合左甲状腺素钠片治疗的疗效。方法选取2017年5月至2019年5月于本院诊治的100例甲减患者,按随机数字表法分为两组,各50例。对照组采用左甲状腺素钠片治疗,观察组在对照组基础上联合甲状腺素片治疗,比较两组疗效及甲状腺功能。结果治疗后,观察组总有效率(86.00%)高于对照组(64.00%),差异有统计学意义(P<0.05);两组治疗后总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平均高于治疗前,而促甲状腺激素(TSH)水平低于治疗前,且观察组TT4、FT3、FT4水平高于对照组,TSH水平低于对照组,差异有统计学意义(P<0.05)。结论甲减患者采用甲状腺素片联合左甲状腺素钠片治疗的效果较好,有利于改善患者的甲状腺功能。     

甲状腺激素对氚致神经元迁移障碍的改善作用

目的 探讨甲状腺激素对氚辐射所致大鼠海马神经元迁移障碍的改善作用.方法 取新生大鼠进行海马神经元培养,培养7d后将细胞随机分为对照组、氚水组、甲状腺激素组和氚水+甲状腺激素组(同时加入3.7×105 Bq/ml氚水与0.3μg/ml甲状腺激素),作用24 h后,用Leica AF 6000活细胞工作站测神经细胞迁移距离;RT-PCR法检测reelin mRNA、BDNFmRNA的变化;Western blot、免疫细胞化学染色法观察神经细胞内β-微管蛋白变化.结果 与对照组相比,氚水组Reelin mRNA、BDNFmRNA和β-微管蛋白的表达量均显著减少(=5.80、5.48、5.47,P＜0.01);而氚水+甲状腺激素组、甲状腺激素组的表达量均显著增加(t=7.75、12.06、13.65,P＜0.01;t=4.34、5.47、5.65,P＜0.01),并明显高于氚水组(t=2.92、10.32、8.76,P＜0.01;t=18.07、20.55、40.13,P＜0.01).氚水组细胞迁移距离明显缩短(t=8.62,P＜0.01);而氚水+甲状腺激素组、甲状腺激素组细胞迁移距离明显延长(t=7.64、4.93,P＜0.01),并明显大于氚水组(t=11.32、12.31,P＜0.01).结论 甲状腺激素对氚辐射造成的神经元迁移障碍具有改善作用.     

Hormonal correlations at transition from reproduction to molting in an annual life cycle of Humboldt penguins (Spheniscus humboldti)

To understand the hormonal mechanism behind a unique strategy of breeding and molting in Humboldt penguins, six pairs of captive Humboldt penguins kept in an outdoor open display pen were observed and blood collected weekly for a year. They all molted between the middle of June and the middle of August within 10 days except one pair that molted about a month later. The late pair had been rearing a hatchling until July due to the successful second clutch after the first clutch failed. A peak of plasma levels of thyroxine and triiodothyronine, respectively, overlapped a period of molting in both sexes. Plasma testosterone concentrations in the males and females were lowest for two month during a period of pre-molt and molting. Plasma concentrations of estradiol were also lowest during the molt in both sexes. Except for the period of molting, sex steroid hormone concentrations were high although there was great individual variation. During the molt, the birds were forced to fast since they did not enter the pool in the display pen where they usually forage live fish. To compensate this forced fasting, they took more food than usual during pre-molting period and gained body mass to about 20% more than the baseline value. Increased flipper thickness was parallel to increased body mass indicating that the gained body mass attributed to fat reservoir. These data indicate that rapid molting in Humboldt penguins is correlated with a drastic increase and decrease of thyroid hormones during the period of lowest concentrations in sex steroid hormones.     

Plasma cortisol and thyroid hormone concentrations in pre-weaning Australian fur seal pups

The hormonal factors that influence development from birth to weaning in otariid seals is still largely unknown. In the present study, a suite of thyroid hormones and cortisol were measured in Australian fur seal pups in order to determine baseline concentrations as well as to describe their endocrinology over this critical developmental period. A cross-section of newborn pups from a breeding colony located on Kanowna Island, Australia were sampled at six different times over the course of the 10 month lactation period. Sample times were designed to correspond to periods of heightened physiological change during pre-weaning development: post-natal, pre-molt, the initiation of molt, mid-molt, period of peak milk intake and weaning. Results indicate that the greatest hormonal changes were associated with the post-natal stage and molt, with molt showing the greatest changes, as has been reported for several species of pinnipeds. Two forms of thyroid hormones analyzed (Total T₄, and Free T₃), increased with the initiation of the molt, and Free T₃ exhibited a second increase that was associated with the period of peak milk intake. The T₃:T₄ ratio was significantly lower during the initiation of molt than either pre- or mid-molt. The study was able to describe physiological change during the first year of life in Australian fur seals as well as document basal concentrations of thyroid hormones and cortisol in pups of this species.     

慢性重度充血性心力衰竭患者血清甲状腺激素和心功能变化的关系

目的观察探讨慢性充血性心力衰竭（CHF）患者甲状腺激素异常变化的临床意义。方法各种病因的CHF患者71例，其中重度CHF23例以及健康对照组25例进行血清甲状腺激素水平的测定。结果发现CHF组中三碘甲状腺原氨酸，激离三碘甲状腺原氨酸。反三碘甲状腺原氨酸与对照组比较有显著差异（P＜0．05），而促甲状腺激素无明显改变。心力衰竭程度越重，激素水平变化越明显。经治疗后激素水平有上升，较前好转。结论血清甲状腺激素变化作为判断CHF严重程度，治疗和预后具有一定临床意义。     

游离甲状腺素化学发光免疫分析方法的建立

目的 采用二抗-甲状腺素抗体固相两步包被法,使用鲁米诺-双氧水-辣根过氧化物酶化学发光体系作为检测体系,建立测定血清中游离甲状腺素的化学发光免疫分析方法.方法 利用竞争法建立游离甲状腺素的检测体系,分别对该体系进行分析性能评估、2016年度内分泌室间质评,并与进口全自动发光试剂盒检测结果进行一致性检验.结果在4~64pmol/L的校准曲线范围内相关系数0.9995,最低检出限为0.54pmol/L,批内和批间精密度均小于7.0%,稳定性结果良好,不影响检测结果.2016年全国室间质评测定结果均在允许范围内,与进口西门子发光试剂盒有很好的临床符合性,两种试剂盒的样本测值差异不具有统计学意义.结论 本方法利用二抗-甲状腺素抗体固相两步包被法,在节约包被原料的同时改善了精密度且提高了灵敏度,最后通过临床血样的一致性评价,与参比试剂盒具有同等的临床使用价值.     

肝硬化患者血清甲状腺激素与透明质酸水平的相关性研究

目的探讨肝硬化患者血清透明质酸含量与肝硬化病变程度及甲状腺激素水平的相关性。方法用放射免疫法测定了６９例不同程度的肝硬化患者血清透明质酸（ＨＡ）含量和甲状腺激素水平。结果随着临床肝硬化程度的加重，ＨＡ含量逐渐增高。而三碘甲状腺原氨酸（Ｔ３）、游离三碘甲状腺原氨酸（ＦＴ３），随ＨＡ的增高而下降，与ＨＡ含量呈显著负相关（ｒ＝－０．６２１和－０．４８４）；而甲状腺素（Ｔ４）、游离甲状腺素（ＦＴ４）可正常或下降，但在肝功能严重衰弱时也多呈低水平。结论肝硬化时，Ｔ３、ＦＴ３与ＨＡ呈显著负相关。联合检测ＨＡ与Ｔ３、ＦＴ３及Ｔ４、ＦＴ４浓度对估测肝硬化的严重程度及预后具有实用价值。     

甲状腺素对原发性甲状腺功能减退症认知功能损害的治疗效果

目的研究甲状腺素对成人原发性甲状腺功能减退症(甲减)患者认知损害的治疗效果。方法运用修订韦氏记忆量表和正背倒背任务检测26例初发成人原发性甲减患者治疗前、后及28例健康对照组的记忆功能。结果修订韦氏记忆量表检测显示,原发性甲减患者记忆商显著低于健康对照组,治疗后记忆商较治疗前明显提高(P<0.05),但仍低于健康对照组(P<0.05)。数字正背倒背任务检测,原发性甲减患者4位倒背数字任务正确率显著低于对照组(P<0.05),治疗后4位倒背数字任务正确率显著提高,与健康对照组未见明显差异(P>0.05)。结论原发性甲减患者存在记忆功能损害,甲状腺素替代治疗能够改善甲减患者的记忆功能。     

50岁以上甲状腺机能亢进症70例临床分析

本文分析50岁以上甲亢患者70例,显示老年前期及老年期患者病程长,临床表现多不典型。浸润性突眼少于中青年组,结节性甲肿显著高于中青年组,而甲状腺摄取(131)碘率及血清T T_s、T T_4 FT_4~1均显著低于中青年组(P<0.01)。口服他巴唑抗甲状腺治疗达到症状控制所需剂量及总天数均少于中青年组(P<0.01)。提示老年甲亢在治疗上要区别于中青年甲亢。