生长激素缺乏儿童在生长激素治疗中血清瘦素水平的改变

为了观察生长激素对血清瘦素 (leptin)的影响 ,用酶联法测定33例青春期前正常儿童和12例生长激素缺乏(GHD)患儿在治疗前、治疗后血清leptin水平 ;同时观察了患儿BMI与leptin的关系。结果显示 ,正常青春期前儿童血清leptin水平为 (1.22±0.94)ng/ml;治疗前GHD患儿血清leptin水平为 (3.079±2.407)ng/ml,与对照组相比差异无显著性(P>0.05) ;GHD患儿治疗后1、3、6个月血清leptin水平分别为 (1.643±1.367)ng/ml、(1.571±1.397)ng/ml和 (1.349±0.893)ng/ml,与治疗前相比差异有显著性 (P均<0.001)。提示生长激素对leptin的表达有抑制作用     

甲状腺激素对大鼠瘦素水平的影响(英文)

目的：下丘脑-垂体-甲状腺轴可能影响瘦素的分泌和代谢。该研究探讨甲状腺功能减低和甲状腺功能亢进时甲状腺激素对血清瘦素水平和脂肪瘦素mRNA水平的影响。方法：应用他巴唑和优甲乐人工造成大鼠甲状腺功能减低和甲状腺功能亢进状态,分别于用药10天、停药10天检测用药组、停药组和正常对照大鼠血清瘦素、T3、T4、TSH浓度、体重和脂肪瘦素的mRNA水平。结果：甲减用药组、甲亢用药组和正常对照组大鼠血清瘦素与体重均有相关性(P<0.05),相关系数分别0.84、0.83、0.94。去除体重因素,甲亢用药组、停药组血清瘦素和脂肪瘦素mRNA水平和正常对照组相比无明显差别(P>0.05),而甲减用药组血清瘦素(0.68±0.07 ng/ml)和脂肪瘦素mRNA水平(0.39±0.02)显著低于停药组(1.98±0.09 ng/ml)(0.87±0.05)和正常对照组(2.14±0.46 ng/ml)(0.95±0.03)(P<0.05)。结论：甲状腺素可能对血清瘦素的稳定分泌起一定的作用。［中国当代儿科杂志,2004, 6(5): 369-372］     

甲状腺功能异常患儿血清瘦素水平与甲状腺激素的相关性研究

目的　研究甲状腺功能异常 [原发性甲状腺功能减退 (甲减 )和原发性甲状腺功能亢进 (甲亢 ) ]患儿血清瘦素 (leptin)水平变化 ,探讨血清瘦素与甲状腺功能的关系。方法　采用放射免疫法分别检测 2 0例甲减患儿、17例甲亢患儿和 2 5例健康儿童血清瘦素水平 ,同时采用微粒子化学发光免疫分析法检测血清游离三碘甲状腺原氨酸 (FT3 )、游离甲状腺素 (FT4)、促甲状腺素 (TSH)等指标。结果　甲低组治疗前血清瘦素水平显著低于正常对照组 (P <0 .0 0 1) ,经药物治疗甲状腺功能恢复至正常后 ,其血清瘦素浓度上升至正常水平 ;甲亢组治疗前后血清瘦素水平与正常对照组相比 ,差异无显著性 (P >0 .0 5 )。结论　甲状腺激素对血清瘦素的分泌具有促进作用     

儿童支气管哮喘血清IL—1、IL—6、IL—8的变化

采用双抗体夹心酶联免疫吸附试验(ELISA)测定40例儿童支气管哮喘发作期、20例缓解期血清白细胞介素1(IL-1)、白细胞介素6(IL-6)、白细胞介素8(IL-8)水平。并设20例健康儿童作正常对照。结果:发作期IL-1(11.90pg/ml±2.84pg/ml)、IL-6(0.75ng/ml±0.30ng/ml)、IL-8(0.08ng/ml±0.05ng/ml)水平明显高于缓解期(8.41pg/ml±0.05pg/ml、0.49ng/ml±0.08ng/ml、0.02ng/ml±0.01ng/ml)及对照组(8.40pg/ml±0.32pg/ml、0.40ng/ml±0.09ng/ml、0.02ng/ml±0.02ng/ml),经统计学处理有显著差异(P<0.01)。且血清IL-1水平与IL-6、IL-8比较呈正相关(γ=0.753,γ=0.795,P<0.01)。提示IL-1与IL-6、IL-8一样参与了哮喘的病理过程,哮喘缓解期仍存在气道炎症反应。细胞因子网络失衡可能是哮喘发病的分子生物学基础。可将血清IL-1、IL-6、IL-8水平升高作为支气管哮喘发作的指标之一。     

瘦素在宫内发育迟缓婴儿追赶生长中的作用

目的通过对胎儿宫内发育迟缓(IUGR)儿与正常儿生后1岁内血清瘦素(Leptin)水平的动态监测,探讨瘦素在IUGR儿追赶生长中的作用.方法随机选择资料完整的新生儿83例,其中IUGR组43例,正常组40例,进行跟踪随访,采用放免法测定血清瘦素水平.结果出生时IUGR儿血清瘦素水平(4.77±2.64)ng/ml,明显低于正常组(8.69±5.52)ng/ml,瘦素与体重指数(BMI)呈显著相关性(IUGR组r=0.37,P＜0.01,正常组,r=0.57,P＜0.001),随月龄增加,IUGR组BMI与正常组比较无显著性差异,而出生3、6、12个月IUGR组血清瘦素水平(ng/ml)明显上升,并显著高于正常组(3.97±1.94比3.42±1.56,4.29±.09比3.78±1.15,4.11±0.98比3.53±1.23),IUGR组瘦素水平与BMI无显著相关性,而正常组瘦素与BMI有一定的相关性.结论IUGR儿瘦素水平的升高可能与瘦素抵抗或脂肪组织功能缺陷有关,瘦素作为生长促进因子参与生后个体的发育,是IUGR儿发生追赶生长的主要原因.     

1型糖尿病患儿血清白细胞介素—6水平的变化及意义

为探讨白细胞介素-6(IL-6)在1型糖尿病发病中的作用,采用ELISA法测定26例1型糖尿病患儿、20例健康儿童血清IL-6水平,糖尿病组还同时测定空腹血糖、糖化血红蛋白(HbA_(1c))、血清胰岛素、C肽。结果显示1型糖尿病患儿血清IL-6水平(12.4pg/ml±4.7pg/ml)明显高于正常对照组(4.1pg/ml±2.3pg/ml),t=7.24,P<0.01;糖尿病患儿中病情控制不良组(HbA_(1c)>10.0％)血清IL-6显著高于病情控制良好组(HbA_(1c)<10.0％),20.8pg/ml±4.8pg/ml对6.4pg/ml±2.7pg/ml,t=9.62,P<0.01;糖尿病组血清IL-6水平与病程、空腹血糖、血清胰岛素、C肽均无相关性(P>0.05)。提示IL-6在儿童1型糖尿病的发病中起一定作用。     

甲状腺激素对大鼠血清瘦素及其mRNA水平的影响

目的探讨甲状腺功能低下(甲低)和甲状腺功能亢进(甲亢)大鼠甲状腺激素对血清瘦素水平和脂肪瘦素mRNA水平的影响。方法应用甲巯咪唑和优甲乐人工造成大鼠甲低和甲亢状态,分别于用药10d、停药10d检测用药组和正常对照大鼠血清瘦素、T3、T4、TSH浓度、体质量和脂肪瘦素的mRNA水平。结果甲低、甲亢和正常对照组大鼠血清瘦素与体质量均有显著相关性(r分别为0.84、0.94、0.83P均<0.05);去除体质量因素,甲亢组、停药10d组和正常对照组相比,血清瘦素和脂肪瘦素mRNA水平无明显差异(P均>0.05),而甲低组血清瘦素和脂肪瘦素mRNA水平显著低于停药10d组和正常对照组(P均<0.05)。结论甲状腺素对血清瘦素的分泌起一定促进作用.     

甲亢患儿治疗中T_3、T_4、TSH同时测定的意义

本文对甲状腺功能亢进症的长期治疗中,测定血中三碘甲状腺原氨酸(T_3)、甲状腺素(T_4)、促甲状腺素(TSH)的意义进行了研究。对象:2岁5个月至21岁3个月,共23例,其中包括新患者5例和治疗停止后复发的6例。观察时间是16个月,治疗药物是丙基硫脲嘧啶(Propylthiouracil或PTU)及他巴佐(Methimazol)。临床上功能亢进时,T_3的血清浓度有异常的高值,T_4是在正常范围。临床上甲状腺功能正常时,T_3为正常值,尽管也可以稍为增高,而T_4可以被抑制在甲状腺功能低下的范围。故在抗甲状腺药物治     

小儿细菌感染对血清瘦素的影响及意义

目的确定瘦素(leptin)与细菌感染性疾病的相关性,探讨leptin改变的调节机制及意义。方法用免疫放射法(IRMA)检测33例细菌感染患儿发病极期和恢复期血清leptin,正常对照组25例,用酶联免疫法测肿瘤坏死因子(TNF-α)。结果(1)在感染极期,血清leptin水平(3.791±3.565)μg/L明显降低,较感染恢复期(P<0.01)和正常对照组(P<0.05),差异均有显著性意义,且重症感染组leptin水平(1.747±2.583)μg/L明显低于普通感染组(5.143±4.370)μg/L,二者差异亦有显著性意义;在感染恢复期,血清leptin水平已近正常,与对照组比较,差异无显著性意义。(2)在感染极期,血TNF-α(32.912±6.664)ng/L水平明显升高,较感染恢复期(P<0.001)和正常对照组(P<0.001),差异均有显著性意义;在感染恢复期血TNF-α水平已近正常,较对照组差异无显著性意义。(3)在感染极期,血清leptin与TNF-α呈负相关(r=-0.537,P<0.01),在恢复期二者无相关性。结论血清leptin测定对感染严重程度和预后的判断有重要意义,对进一步探讨内分泌与免疫网络的关系有一定的参考价值。     

甲状腺素在婴幼儿肺炎心力衰竭时的变化及意义

我科1993年10月至1994年4月对40例年龄在1月～3岁、诊断为肺炎并发心力衰竭的婴幼儿进行了血清甲状腺素(包括T_3、T_4、rT_3、T_3/rT_3)的检测,且观察血清甲状腺素与疗效的关系,同时以30例正常婴幼儿血清甲状腺素作为对照。结果,肺炎心衰组血T_3为1.00±0.29nmol/L,T_4为84.3±25.4nmol/L,rT_3为2.00±0.62nmol/L,T_3/rT_3为0.56±0.33。对照组依次为1.72±0.52nmol/L、109.0±30.1nmol/L、0.5±0.07nmol/L、4.59±1.32。肺炎心衰治疗组为1.58±0.22nmol/L、90.1±19.9nmol/L、rT_30.65±0.12nmol/L、T_3/     

Ectopic Thyroid: Residual Function after Withdrawal of Treatment in Infancy and Later Childhood

ABSTRACT. Plasma thyroxine (T4) and thyrotrophin (TSH) were estimated in 34 children identified by neonatal hypothyroid screening and subsequently found to have ectopic thyroid tissue on isotope scan. Before treatment plasma T4 ranged from 8–143 nmol/1 and TSH from 39–1230 mU/l. After one week off treatment during their second year, repeat T4 in 26 of these cases showed a significant correlation with the pre-treatment values ( r = 0.57). However, only 3 of the 5 children with pre-treatment T4 levels over 100 nmol/1 at diagnosis had normal T4 values when retested. Similarly, when 10 children with pre-treatment T4 values over 65 nmol/1 were retested off treatment at the ages of 5.8–8.2 years, only 4 had plasma T4 levels in the normal range. These results illustrate the wide range of thyroid function which can occur in children with ectopic thyroid tissue and indicate that some continue to have near-normal thyroid function for considerable periods. However, pre-treatment T4 results do not allow accurate identification of these latter cases.     

Functioning lingual and median ectopic cervical thyroid

The combination of lingual thyroid and median ectopic cervical thyroid in the same patient has not been described previously. A 10-year-old girl presented with a midline anterior neck tumour initially thought to be a thyroglossal cyst. Examination revealed a lobulated, nontranslucent lesion and a noncontiguous lingual thyroid. Thyroid scan showed two separate areas of thyroid activity.     

Imaging of pediatric thyroid tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

Pediatric thyroid cancer is rare in children; however, incidence is increasing. Papillary thyroid cancer and follicular thyroid cancer are the most common subtypes, comprising about 90% and 10% of cases, respectively. This paper provides consensus imaging recommendations for evaluation of pediatric patients with thyroid cancer at diagnosis and during follow-up.     

Aetiology of Congenital Hypothyroidism in Finland

ABSTRACT. In Finland a nationwide screening programme for congenital hypothyroidism (CHT) has operated since 1980 with complete coverage. Among the total of 307000 newborns screened, the incidence per 100 000 was 24.6 for thyroid dysgenesis and 4.0 for dyshormonogenesis. We conclude that, when screening is based on cord serum TSH, the false-positive results are caused mainly by difficult delivery. The most important factors associated with dyshormonogenesis were CHT in the family, origin from a geographic risk area, and origin of both mother and father from the same community. These reflect the autosomal recessive inheritance. The risk factors for dysgenesis were female gender, CHT in the family, birth in a geographic risk area, and birth during a risk period of the year     

Hyperfunctioning Thyroid Nodules in Children and Adolescents

ABSTRACT. Eight children and adolescents, seven female and one male, aged 7.1 to 15.0 years, referred over a 12-year period for a solitary mass in an otherwise normal thyroid gland, exhibited a hyperfunctioning nodule on thyroid scintiscan. Tracer uptake in the surrounding thyroid tissue was reduced or completely suppressed, but could be restored after TSH stimulation. Only one patient had mild clinical hyperthyroidism with normal T4 but increased T3 serum levels and blunted TSH responsiveness to TRH. A similar hormonal pattern suggestive of subclinical hyperthyroidism was found in three other subjects who were clinically euthyroid. One patient initially euthyroid progressed to subclinical hyperthyroidism two years later. In the whole group a significant negative relationship was found between serum T3 level and TRH-stimulated TSH peak (r= -0.829, p<0.02). All the patients underwent selective surgery after a 3-month to 2-year period of follow-up. Microscopic examination was consistent with adenoma in seven patients, while in one case a well-encapsulated papillary adenocarcinoma was found. Though hyperfunctioning nodules are seldom malignant, their surgical removal must be recommended when they become thyrotoxic, exceed 3 cm or show progressive enlargement.     

儿童甲状腺癌与自身免疫性甲状腺疾病相关性研究

目的：探讨儿童甲状腺癌与自身免疫性甲状腺疾病之间的关系。方法回顾性分析2000年至2008年行甲状腺切除术并经病理确诊为甲状腺癌的68例患儿的临床资料,比较伴发与不伴发自身免疫性甲状腺疾病的甲状腺癌患儿的年龄、性别、结节大小、淋巴结转移、侵袭状态等临床及病理特征。结果68例甲状腺癌患儿中,31例(45.6%)伴发自身免疫性甲状腺疾病;与37例未伴发自身免疫性甲状腺疾病的患儿相比,伴发自身免疫性甲状腺疾病患儿中女性比例更高、年龄更大、结节直径更小、促甲状腺激素水平和甲状腺球蛋白水平更高、生存时间更短,无病生存比例低、复发率高,差异均有统计学意义(P<0.05)。结论儿童自身免疫性甲状腺疾病与甲状腺癌的关系密切,对自身免疫性甲状腺疾病患儿应加强随访。