TSH受体抗体测定的临床意义

促甲状腺激素受体抗体是直接作用于甲状腺胞膜上的促甲状腺激素受体的多克隆抗体，为自身免疫性甲状腺疾病的体液免疫。     

TSH受体抗体测定的临床意义

促甲状腺激素受体抗体(TRAb)是直接作用于甲状腺细胞膜上的促甲状腺激素(TSH)受体的多克隆抗体,为自身免疫性甲状腺疾病(AITD)的体液免疫。TRAb的测定在诊断自身免疫性甲状腺疾病格雷氏病(GD)及桥本氏病(HD);鉴别诊断亚急性甲状腺炎、甲状腺功能自主性结节或腺瘤;预测新生儿甲亢;判定GD疗效与预测GD复发;检测GD患者家属中有无自身免疫性甲状腺疾病的倾向以及对其它自身免疫性疾病进行辅助性检测等具有重要以及程度不等的临床意义。     

糖尿病患者生长激素和甲状腺激素代谢的变化及其临床意义

糖尿病患者的激素代谢紊乱与其病情的发生、发展及预后密切相关。作者观察了糖尿病患者生长激素及甲状腺激素的代谢变化 ,旨在探讨其对糖尿病患者的影响。1　资料与方法糖尿病组 :选择已确诊的 2型糖尿病患者 5 0例 ,男 31例 ,女19例 ,年龄 5 3 7±8 9岁。正常对照组 :轻度单纯肥胖者 38例 ,男2 3例 ,女 15例 ,均排除糖尿病及其他各种内分泌疾病。所有受试者均于清晨空腹及早餐后 2ｈ抽取静脉血用于测定血糖 (Ｇｌｕ)及生长激素 (ＧＨ)水平 ;另抽取清晨空腹静脉血用于测定三碘甲状腺原氨酸 (Ｔ3 )、甲状腺素 (Ｔ4)、游离Ｔ3 (ＦＴ3 )、游离…     

急性一氧化碳中毒患者血清甲状腺素测定及临床意义

目的：探讨急性一氧化碳中毒时血清甲状腺激素的变化及意义。方法：以25例急性一氧化碳中毒患者和20例健康成年人为研究对象,采用放射免疫地测定甲状腺激素。结果：①中毒组T3、FT3明显低于对照组,且中毒越重下降越明显（P＜0．01）;②各组间T4、TSH无显著性差异（P＞0．05）;③中毒组FT4低于对照组（P＜0．01）。结论：急性一氧化碳中毒时甲状腺激素明显下降,且与病情严重性有关,可作为中毒程度的一个监测指标。     

肝癌患者肝移植术前、术后血清T3、T4放射免疫测定临床意义

为了解肝癌患者肝移植术前及术后血清甲状腺激素水平,我们对75例肝移植患者进行了术前、术后血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)的放射免疫测定,现将结果报告如下。1对象和方法1.1对象正常对照组:35例,均选自我院健康体检合格者,无甲状腺疾病及心、肝、肾、肺等重要脏器疾患,其中男15例,女20例,年龄19~51岁。肝癌患者肝移植组:75例,均经临床通过B超、CT或核磁共振及检验等检查确诊,其中男70例,女5例,年龄27~62岁,均无甲状腺疾病症状和体征。1.2方法晨起采空腹静脉血3ml,低温离心后取血清置于-20℃冰箱内保存,同批测定。T3、T4试剂盒…     

糖尿病患者肾阈测定的临床意义

本文对65例糖尿病人进行了肾糖阈测定,结果发现44.6％的糖尿病患者肾糖阈异常,其中15例肾糖阈降低,占23.1％,血糖在2.8—5.9mmol/L时仍有糖尿排出(+—(?)),14例肾糖阈升高,占21.5％,血糖在11.2—14.5mmol/L时尿糖仍阴性。糖尿病人肾糖阈改变与患者年龄,病程、上糖值无关,P>0.05。 糖尿病人有肾糖阈异常,尿糖测定就不能正确反映其血糖水平,肾糖阈降低的患者,临床上会呈现控制不良假象。肾糖阈升高的患者,又会造成用药量偏小,使血糖不能及时得到满意控制。因此用尿糖作为糖尿病患者的病情监测并指导合理用药时,有必要对糖尿病人进行肾糖阀定。     

50例脑梗塞患者血清T3,T4,TSH RIA测定的临床观察

５０例脑梗塞患者血清Ｔ_３、Ｔ_４、ＴＳＨＲＩＡ测定的临床观察武警总医院放免室王宏煜，蒋福才（北京１０００３９）脑血管疾病有关内分泌方面的病理、生理变化受到普遍关注。我们采用放射免疫（ＲＩＡ）方法，测定了５０例脑梗塞患者血清Ｔ３、Ｔ４、ＴＳＨ，并进行了...     

糖化血红蛋白测定在糖尿病诊断中的临床意义

根据相关文献研究数据表明,伴随着我国人口老龄化形势的日益严峻,这使得糖尿病患者的发病率呈现飞速发展的趋势,增长的速度甚至达到了每天新增3000例,成为了全球公认的仅次于心血管疾病、肿瘤疾病的第三大严重危害人类身心健康的慢性疾病[1].糖尿病是一种较为普遍的全身性代谢性疾病,多表现为持续性高血糖,是一种以高血糖为主要表现,蛋白质、糖和脂肪均同时出现代谢紊乱的综合性疾病.此外,糖尿病还可引起一系列的肾病、脑血管病等并发症.引起该病的主要因素是,胰岛素分泌出现绝对或者相对不足.根据2010年美国糖尿病学会提出的关于糖尿病诊断的相关内容来看,已将糖化血红蛋白(HbAlc)作为糖尿病诊断的重要方法,并认为当HbAlc≥6.5％为糖尿病的切入点,这使得HbAlc在糖尿病诊断中的地位得到了明确.鉴于此,笔者运用HbAlc对糖尿病进行诊断中,现将相关情况总结如下.     

2型糖尿病患者C肽浓度测定的临床意义探讨

目的研究血清C肽浓度测定的临床意义。方法160例2型糖尿病患者，以60岁为界分为老年组和非老年组；以病程10年为界分为2组；按WHO对亚太地区的肥胖分级标准以体重指数24为界分为2组。所有患者入院检查，计算体重指数（BMI），BMI=体重（kg）／身高（cm）^2，取空腹静脉血进行C肽释放试验：进食标准馒头餐（含糖量为75g），分别于餐后1h、2h、3h采血，分离后血清置20℃待检。采用酶联免疫分析法测定。结果不同病程间C肽比较：以病程10年为界，两组间除1hC肽水平接近外，其他时点短病程组均高于长病程组；不同年龄组间C肽比较：〈60岁组各时点C肽值均高于〉60岁组，差异有显著性；不同肥胖程度间C肽释放水平比较，统计学分析显示，不同BMI间C肽值均存在差异，C肽不同时点间有差别，各时间点C肽含量依次升高。至2h最高，3hC肽含量下降。BMI与时间的交互作用对C肽的影响有统计学意义。结论C肽的测量对内源性胰岛素的分泌能力评价更具有临床意义，并可间接评估糖尿病慢性并发症的发生。     

Clinical significance of intramammary arterial calcifications in women with diabetes mellitus

BACKGROUND: It is well known that intramammary arterial calcifications, diagnosed by mammography as a part of generalized diabetic macroangiopathy, may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient's age when the calcifications occur, as well as to observe the influence of diabetic polyneuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. METHODS: Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polyneuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. RESULTS: Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%), in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. CONCLUSION: The obtained results supported the theory that intramammary arterial calcifications, detected by mammography, could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.     

糖尿病患者心电图改变的临床研究

目的观察和分析2型糖尿病患者心电图异常情况,以进一步加深对糖尿病心脏损伤的认识。方法对369例2型糖尿病患者常规和动态心电图进行分析,并与年龄、性别、基础疾病相匹配无糖尿病的对照组比较。结果糖尿病组最高心率（113±8）次/min较对照组（98±8）次/min显著增高,最低心率（51±10）次/min较对照组（66±8）次/min明显减低,心律失常较对照组明显增加,其中窦性196/43、房性307/99、交界性78/22、室性301/126、传导异常178/41、ST-T缺血性改变也均较对照组显著增多（ST段221/68、T波192/63）,差异有统计学意义（P〈0.05）。结论 2型糖尿病患者易发生心电图异常,可能与高血糖和低血糖对心脏损害等有关。     

C肽和胰高血糖素测定对肝源性糖尿病的临床意义

目的探讨C肽释放试验及胰高血糖素测定对肝源性糖尿病(HD)的临床意义。方法对102例HD、95例2型糖尿病(T2DM)及110例正常对照者(NC)行葡萄糖耐量试验,测定不同时间点血糖、胰岛素、C肽及胰高血糖素水平。采用稳态模型法的胰岛β细胞功能(Homa-β)、同样方法的胰岛素抵抗指数(Homa-IR)及空腹血糖/空腹胰岛素(FPG/FINS)来评估胰岛素抵抗,用胰岛素敏感指数(ISI)评估胰岛素敏感性。结果 HD组FPG低于T2DM组(P<0.05),胰岛素分泌呈高峰延迟型,60、120 min胰岛素及C肽高于T2DM组(P<0.05)。HD组Homa-β及ISI高于T2DM组,FPG/FINS低于T2DM组(P均<0.05)。T2DM组Homa-IR高于NC组,ISI低于NC组(P均<0.05)。HD组胰高血糖素水平高于NC组及T2DM组(P<0.05),60 min达到高峰,180 min恢复正常。结论 C肽释放试验及胰高血糖素测定对鉴别HD有一定价值,对肝细胞损伤程度的判定及预后有一定的临床意义。     

Plasma TSH, T3, T4 and cortisol responses to swimming at varying water temperatures.

The acute effect of 30-min swimming at a moderate speed, at three water temperatures (20, 26 and 32 degrees C) on plasma thyroid stimulating hormone (TSH), free thyroxine (F.T4), triiodothyronine (T3) and cortisol concentrations was studied in 15 élite male swimmers. Blood was sampled before and immediately after the events. The heart rate, which was continuously monitored during exercise, had the highest response at 32 degrees C and the lowest at 20 degrees C. Blood lactate concentrations were found to be similar after the three tests. Plasma TSH and F.T4 were found to be significantly increased (by 90.4% and 45.7% respectively) after swimming at 20 degrees C, decreased at 32 degrees C (by 22.3% and 10.1% respectively) and unchanged at 26 degrees C. Exercise at these three water temperatures did not significantly affect T3. Finally, plasma cortisol was found to be increased after swimming at 32 degrees C (by 82.8%) and 26 degrees C (by 46.9%), but decreased at 20 degrees C (by 6.1%).     

急性盆腔炎患者CRP、IL-2及T细胞亚群测定的临床意义

目的：检测急性盆腔炎CRP（C-反应蛋白）、IL-2（白细胞介素-2）和T淋巴细胞亚群水平的临床意义。方法：血清CRP测定采用免疫透射比浊法，IL-2测定采用EHSA法，T淋巴细胞亚群采用APAAP法。结果：与对照组比较，急性盆腔炎患者血清CRP水平显著升高（P〈0．01），IL-2水平和CD3^＋、CD4^＋及CD4^＋／CD8^＋比值明显降低（P〈0．01）。结论：急性盆腔炎患者细胞免疫功能低下和紊乱，易致反复感染，CRP是急性盆腔炎早期诊断、病情监测、疗效判定的敏感指标。     

Hypergravity effects on litter size, nursing activity, prolactin, TSH, T3, and T4 in the rat

Hypergravity (HG) adapted rats were tested for mating ability, gestational time, fetal and newborn mortality, and nursing performances. Plasma and pituitary PRL and TSH and plasma T3 T4 were determined during 48 h peripartum. No difference was noticed in mating ability and gestation time. The number of fetuses was reduced in the HG rats (1 G- 12.9 +/- 0.5, 2.16 G-10.5 +/- 0.4, 3.14 G-9.4 +/- 0.5). None of the 3.14 G rats nursed their young, all of which were cannibalized. Of the 2.16 G rats, 50% nursed their pups, of which only half survived to weaning. The initial pituitary PRL of HG rats was lower than 1 G, but it increased postpartum, while the plasma PRL, which was very low, continued to decrease. Only postpartum was there a difference in plasma PRL between rats that previously nursed and those which did not nurse at 2.16 G. HG rats had lower T3 levels, indicating a hypermetabolic state during the peripartum, which worsened their normal relative hypothyroid state of pregnancy. Our conclusions are that exposure of pregnant rats to HG above 3 G has a lethal effect on the fetuses and newborns. Maternal PRL and T3 changes are possible reasons for this.     

糖尿病合并细菌性肝脓肿的临床及病理学特点

目的 总结糖尿病(DM)合并细菌性肝脓肿(PLA)患者的临床及病理特点.方法 回顾性分析2001年1月-2010年12月解放军306医院收治的42例DM合并PLA患者的临床表现,实验室、影像学、病理学检查资料以及治疗方法.结果 42例患者均获治愈,无死亡病例,疗程19 ～ 57d,平均住院时间29.7d.33例患者经微创外科技术治疗,其中10例行超声引导下经皮肝穿刺抽脓术(PNA),23例行肝穿刺置管引流术(PCD),3例接受开腹肝部分切除术.行PNA术者中,6例经1次穿刺后治愈,3例经2次穿刺后治愈,l例行第3次穿刺.行PCD术者平均8.6d后拔除引流管.手术患者均于术后第3～4天体温恢复至正常,未见并发症.病理学检查显示脓腔内大量纤维间隔,脓肿周围肝组织炎性细胞浸润,肝细胞内糖原颗粒减少,角蛋白8(CK-8)表达明显上凋(P＜0.05),胞质内可见Mallory小体.结论 DM患者机体的特殊性使得在此基础上发生的PLA表现特殊,临床上应提高对该症的认识.     

化学发光法快速检测FT3,FT4,TSH

目的寻找一种快速、准确、灵敏的FT3,FT4,TSH的测定方法。方法利用ACS发光仪及其配套试剂测定FT3,FT4,TSH。结果ACS发光仪常规测定线性范围FT30.5~2 0 ng/L,FT40.1~1 3μg/L,TSH 0.0 3~1 5 0 IU/L,批内变异系数均<5%,批间变异系数均<1 0%;平均回收率100.24%。对35例甲亢、25例甲低与正常人血清FT3,FT4,TSH测定值相比均有显著差异(P<0.05)。结论ACS发光仪测定FT3,FT4,TSH快速、准确、灵敏、线性范围广,更适合急诊检验,对于甲亢、甲低病人的及早发现与治疗有着非常重要的作用。