更年期女性非胰岛素依赖型糖尿病患者性激素与微血管病变的关系

目的：探讨更年期女性非胰岛素依赖型糖尿病（NIDDM）患者血清性激素变化与微血管并发症的关系。方法：应用放射免疫法检测了40例40－60岁更年期女性NIDDM患者血清雌二醇（E2）、睾酮（T）、卵泡刺激素（FH）和黄体生成素（LH）水平，并与26例同年龄段正常更年期妇女进行对比。结果：NIDDM患者组E2和T均较正常的对照线显著降低（P＜0．02和P＜0．05）；NIDDM患者组中伴有微血管并发症者的E2和E2／T较无微血管并发症者更为降低（P＜0．05和P＜0．02）；而FSH和LH在2组间均无显著性差异（P均＞0．05）。结论：更年期女性NIDDM患者性激素失调可能是基微血管并发症发生或促成因素之一。     

糖尿病急性代谢紊乱与血清甲状腺激素的关系探讨

目的：探讨糖尿病急性代谢紊乱与血清甲状腺激素的关系。方法：用放射免疫法测定受试者血清T3、T4、FT3、TSH的水平,用己糖激酶法测定血糖。结果：糖尿病急性代谢紊乱患者血清T3、FT3水平明显降低（P＜0．01）,T4、FT4、TSH变化不明显（P＞0．05）,治疗后T3、FT3明显上升（P＜0．001）。治疗前T3、FT3均与空腹血糖（FBG）、餐后2h血糖（PBG)呈负相关（P＜0．001）。结论：血清甲状腺激素水平变化与糖尿病急性代谢紊乱、病情轻重有关,测定血清T3、FT3、T4、FT4对糖尿病病情估计、判断预后以及疗效有重要意义。     

奥曲肽对大鼠脑损伤后血浆内皮素等激素的影响

测定大鼠脑损伤所致应激反应时血浆内皮素、皮质醇、胃动素、生长抑素和血清胃泌素含量．观察应用奥曲肽后对血中上述激素的影响，以探讨奥曲肽抗应激反应的作用机理。用液压打击致大鼠重度脑损伤后血浆内皮素、皮质醇和血清胃泌素含量显著升高（分别为P＜0．05，P＜0．01，P＜0．01），而血浆生长抑素含量显著降低（P＜0.01），胃动素无显著变化。采用奥曲肽小剂量（4μg／kg．12h）和大剂量（6μg／kg．12h）治疗，均能显著降低血清胃泌素含量，使血浆生长抑素含量增加．其降低胃泌素含量的作用在小剂量和大剂量治疗组之间无显著差异，其升高血浆生长抑素含量的作用大剂量治疗组更显著。奥曲肽能降低大鼠脑损伤后血清胃泌素含量，升高血浆生长抑素含量，可能为其抗应激反应的重要机制。     

T3水平对慢性阻塞性肺疾病营养状况的影响

目的：探讨慢性阻塞性疾病（COPD）营养状况与甲状腺激素水平的关系，以进一步阐明COPD并发营养不良的机制。方法：对53例COPD患者进行系统的身体测量和内脏蛋白测定，同时检测其血清甲状腺素（T3、T4）和促甲状腺激素（TSH）水平。结果：发现COPD混合型营养不良组T3、T4水平显著下降（P＜0．05－0．01），而单纯消瘦组甲状腺激素水平与营养正常组无显著差异（P＞0．05）。T3与所有营养参数均呈显著相关性（P＜05－0．001），T4仅与白蛋白相关（P＜0．05），TSH与各营养参数均无相关性（P＞0．05）。结论：甲状腺激素T3水平与COPD营养状况密切相关，COPD低蛋白血症与患者甲状腺激素水平下降而影响其蛋白质合成有关。     

血液病患者血清LDH水平变化及临床意义

目的 观察血液病患者血清乳酸脱氢酶（LDH）水平变化特点及临床意义。方法 LDH活性的测定采用连续监测法。结果 白血病、自身免疫性溶血性贫血（AIHA）、巨幼细胞性贫血（MA）、患者血清清LDH水平显著升高（P＜0．001）,经治疗缓解或贫血纠正后血清LDH水平显著下降,与治疗前相比差异显著（P＜0．01）。再生障碍性贫血（AA）患者治疗前后无显著性变化（P＞0．05）与对照组相比也无显著性差异（P＞0．05）。结论 检测白血病、MA、AIHA患者血清LDH水平变化,有利于疾病的诊断和疗效的观察。     

急性脑血管病现变性质量严重程度与血浆内皮素-1浓度的关系

目的：主要是探讨急性脑血管病患者病变性质、严重程度与血浆内皮素－1（ET－1）浓度的关系。方法：应用放射免疫方法测定87例急性脑血管病人血浆ET－1浓度并与42例正常人进行比较。结果：脑出血与脑梗塞组血浆ET－1浓度明显高于对照组（P＜0．001），而脑梗塞组血浆ET－1浓度比脑出血组升高，但未有统计学意义（P＞0．05）。急性脑血管病重型者比轻型者血浆ET－1浓度明显升高（P＜0．01），合并高血压者血浆ET－1浓度较正常对照组显著升高（P＜0．001），而与血压正常组相比较二者无显著性差异（P＞0．05）。结论：提示急性脑血管病患者血浆ET－1浓度升高与病变严重程度、血压升高有一定关系，与病变性质虽无统计学意义，但脑梗死者也较脑出血组升高，表明ET－1作为一种内源性血管活性肽在急性脑血管病的预后和发病机制方面是一种有害的介质。     

连续性血液净化治疗对脓毒症患者细胞免疫功能的影响

目的探讨连续性血液净化(CBP)治疗对脓毒症患者细胞免疫功能的影响。方法对21例脓毒症患者在CBP治疗前后采血,用流式细胞术测定T淋巴细胞亚群CD3~ 、CD4~ 、CD8~ 、CD4~ /CD8~ 比值,同时检测血及废液中肿瘤坏死因子-α(TNF-α)浓度,观察CBP治疗前后T淋巴细胞亚群、TNF-α的变化。结果CBP治疗后APACHEⅡ评分降低(P＜0．001),CD3~ 、CD4~ 、CD4~ /CD8~ 比值均较CBP治疗前升高(P＜0．001、P＜0．001、P＜0．05),而CD8~ 差异无统计学意义(P＞0．05),TNF-α浓度无明显变化(P＞0．05)。结论CBP治疗可以改善脓毒症患者的细胞免疫功能,对T淋巴细胞亚群具有双向调节作用。     

男性心绞痛患者白细胞性激素受体的变化

用放免法和放射配体结合法分别测定男性心绞痛病人血清性激素和白细胞性激素受体水平。结果表明与正常对照组相比，心绞痛组血清睾酮（T）和白细胞雄激江素最大的特异结合容量显著降低（P＜0．01）;血清雌二醇／每酮（E2／T）比率和白细胞雌江亲王大特异结合容量明显升高（P＜0．05～0．01），血清单二醇水平和雌激素及推激素受体的亲和力则无明显变化（P＞0．05）。揭示由血清睾降低引起的性激素失衡及性激素受体失衡是男性心绞痛的重要致病因子之一。     

类胰岛素样生长因子-1和抑制素与多囊卵巢综合征相关性分析

目的 为探讨类胰岛素生长因子（IGF-1）和抑制素（INH）在多囊卵巢综合征（PCOS）发病中的作用。方法 检测30例PCOS患者血清类胰岛素生长因子-1（IGF-1）、空腹胰岛素（IN）。抑制素（INH），瘦素（Leptin），黄体生成素（Ln）、卵泡刺激素（FSH）、人体催乳素（PRL）、雌二醇（E2）和睾酮（T）。并取20例排卵正常、无怀孕妇女进行对照。结果 PCOS组IGF-1、IN、INH、LEP、T、LH均高于正常对照组，并有显著性意义（P〈0．05）。且IGF-1与INH呈正相关（r=0．7194，P〈0．01），INH与T也呈正相关（r=0．4343,P〈0．05）。FSH、PRL、E2随均低于正常对照组。结论 IGF-1和INH在多囊卵巢综合征（PCOS）中异常升高。     

窒息对新生儿多种内分泌激素的影响

目的：评价窒息缺氧对新生儿瘦素，胰岛素，生长激素，甲状腺素，糖皮质激素及体重的影响。方法：应用放射免疫法测定23例（窒息组）中，重度窒息缺氧新生儿及无窒息12例（对照组）新生儿静脉血血浆瘦素，胰岛素，生长激素，甲状腺素，皮质醇水平。结果：窒息组新生儿出生后5d体重增长下降（P＜0．05），出生后24－48h血浆生长激素，甲状腺素水平明显低于对照组（分别P＜0．01，P＜0．05）；而瘦素，皮质醇，胰岛素明显高于对照组（分别为P＜0．05，P＜0．01，P＜0．05）。出生后第5d上述5种内分泌激素水平才接受正常。结论：窒息缺氧影响新生儿多种内分泌激素变化，不利于生长，发育，提出可能纠正的方法。     

急性脑血管病患者血清和脑脊液三碘甲状腺原氨酸、甲状腺素及促甲状腺激素含量的变化及其临床意义

对６５例急性脑血管病（ＡＣＶＤ）患者血清与脑脊液（ＣＳＦ）中三碘甲状腺原氨酸（Ｔ３）、甲状腺素（Ｔ４）及促甲状腺激素（ＴＳＨ）的含量进行了测定，发现脑出血组与脑梗塞组血清与ＣＳＦ中Ｔ３、Ｔ４明显低于正常对照组（Ｐ均＜０．０１），ＴＳＨ则明显高于对照组（Ｐ＜０．０５）；且脑出血组Ｔ３、Ｔ４明显低于脑梗塞组，ＴＳＨ则高于脑梗塞组；病情轻重与甲状腺激素的变化明显相关（Ｐ＜０．０５）；治疗前后甲状腺激素水平明显不同，治疗后Ｔ３、Ｔ４明显升高（Ｐ均＜０．０５），以Ｔ３升高最明显（Ｐ＜０．０１）。作者并就其改变机制及临床意义进行了初步讨论。     

Gastrointestinal hormone profile in renal insufficiency

Fasting serum gastrin, cholecystokinin, glucagon, and gastric inhibitory polypeptide concentrations were simultaneously measured in normal subjects and in patients with different degrees of renal failure. Values of gastrin, cholecystokinin, gastric inhibitory polypeptide, and glucagon were significantly higher in all patients with serum creatinine concentrations greater than 3 mg/dl than in controls (P less than 0.01). The degree of renal insufficiency was significantly correlated (P less than 0.05) with serum concentrations of each hormone, but no significant linear correlation existed among the serum concentrations of different gastrointestinal hormones in individuals. Hemodialysis did not significantly alter predialysis serum gastrin, cholecystokinin, or glucagon concentration, but the serum gastric inhibitory polypeptide concentration decreased by 30% (P less than 0.01) after hemodialysis. The disproportionate increases of hormones with antagonistic actions may alter gastrointestinal function in renal insufficiency.     

The effect of erythropoietin treatment on endocrine organ function in patients with terminal-stage kidney failure on hemodialysis

Eleven hemodialyzed patients with uremia were examined for the effect of erythropoietin (EP) treatment carried out for 3 months on functions of different endocrine organs. EP treatment resulted in a decrease of the initial plasma levels of somatotropin, prolactin, follicle-stimulating and luteinizing hormones. EP treatment being over, there was a decrease in the plasma content of ACTH, cortisol and aldosterone. The treatment with EP was also associated with an insignificant rise of the plasma levels of parathyroid hormone and testosterone. EP treatment did not influence the plasma concentration of calcitonin and 25-OH-D. EP was found to exert no significant effect on the pituitary-thyroid reverse relationship. The 3-month treatment with EP eventuated in plasma renin activity inhibition as well as in an increase of the atrial level of natriuretic peptide in the plasma. EP treatment stimulated insulin secretion and reduced glucagon secretion. Finally, EP decreased the gastrin level and to a less degree the plasma level of pancreatic polypeptide.     

Insulin sensitivity and counter-regulatory hormones in hypothyroidism and during thyroid hormone replacement therapy.

We examined insulin sensitivity and secretion, together with the levels of selected glucoregulatory hormones, in 15 female patients with severe hypothyroidism (H) and during subsequent thyroid hormone replacement therapy (HRT) using the euglycaemic hyperinsulinaemic clamp technique. Insulin action, as evaluated by glucose disposal, the insulin sensitivity index, and fasting post-hepatic insulin delivery rate were established. The basal levels of insulin, C-peptide and counter-regulatory hormones were measured in basal condition. In H, glucose disposal (p<0.01), the insulin sensitivity index (p<0.01) and post-hepatic insulin delivery rate (p<0.05) were significantly lower than during HRT. No significant changes in the levels of fasting insulin and C-peptide were observed. The levels of counter-regulatory hormones in patients with H were significantly higher than during HRT (glucagon, p<0.05; epinephrine, p<0.01; cortisol, p<0.05; growth hormone, p<0.05). In H, an inverse correlation between insulin sensitivity and insulin secretion was observed (p<0.05). Cortisol was the most important factor affecting the variability of insulin sensitivity values, regardless of thyroid function (p=0.0012). In conclusion, H altered both insulin sensitivity and the levels of selected counter-regulatory hormones. The situation was restored by HRT, as manifested not only by normalisation of insulin sensitivity, secretion and levels of glucoregulatory hormones, but also by improvement of their relationships.     

子宫内膜癌患者胰岛素及性激素水平的临床研究

目的探讨子宫内膜癌患者与体内性激素及胰岛素水平变化的相关性。方法随机抽取妇科经病理确诊并收治住院的125例子宫内膜癌患者作为研究组,另选择92例正常妇女作为对照组。采用酶联免疫法检测观察组和对照组胰岛素(INS)、血清孕酮(P)、雌激素(E2)、黄体生成素(LH)、促卵泡生成素(FSH)、睾酮(T)及泌乳素(PRL)水平,并根据两组绝经前和绝经后分别进行统计分析。结果较之对照组,绝经前研究组妇女INS、E2、LH水平升高明显,差异具有统计学意义(P<0.05),P水平明显降低,具统计学差异(P<0.05)。而PRL、FSH水平无显著性差异(P>0.05);绝经后研究组妇女INS、E2、LHS水平显著升高,具有统计学差异(P<0.05),FSH水平则降低明显,差异具有统计学意义(P<0.05),而P、PRL、T水平无显著性差异(P>0.05)。结论绝经前后子宫内膜癌患者均存在INS、E和LH水平异常,而绝经前后患者PRL水平无相关改变。     

Alterations of serum lipids in breast cancer: effects of disease activity, treatment, and hormonal factors.

Fasting venous blood collected from 83 patients with breast cancer was analyzed for triglycerides; total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol; tumor necrosis factor (TNF alpha); glucose; creatinine; insulin; glucagon; growth hormone; cortisol; and thyrotropin. Patients with stage IV disease had significantly higher (P less than 0.05) triglyceride concentrations and significantly lower (P less than 0.05) concentrations of total and HDL cholesterol than did patients with less advanced disease or age-matched controls. Furthermore, LDL cholesterol concentrations in patients with boney metastases were significantly lower (P less than 0.05) than concentrations in patients with liver or liver plus boney metastases or in controls. These results could not be attributed to smoking habits, alcohol consumption, or treatment. We observed no correlations between serum concentrations of lipid and concentrations of TNF alpha, insulin, glucose, creatinine, cortisol, growth hormone, or thyrotropin. However, there was a significant (P less than 0.05) negative correlation between total cholesterol and glucagon and between LDL cholesterol and glucagon for patients with stage II, III, and IV disease, suggesting that glucagon may reduce LDL cholesterol concentrations by an as-yet-unidentified mechanism.     

心肌梗死患者溶栓前后甲状腺激素水平临床观察

目的观察急性心肌梗死（AMI）患者溶栓前后甲状腺激素水平的变化,并且探讨其临床意义。方法 AMI溶栓患者48例,以门诊体检40例作为正常对照组;所有患者均用化学发光免疫分析仪分别测定溶栓前、溶栓后48小时血清三碘甲状腺原氨酸（T3）、甲状腺素（T4）以及促甲状腺激素（TSH）。结果①AMI组溶栓前血清甲状腺激素水平与正常对照组比较差异有统计学意义（P〈0.05）：T3（1.01±0.35）nmol/L vs（1.71±0.37）nmol/L;②溶栓后48小时甲状腺激素水平较溶栓前明显升高,差异有统计学意义（P〈0.05）：T3（1.01±0.35）nmol/L vs（1.72±0.43）nmol/L。结论 AMI早期即出现低甲状腺激素水平,溶栓治疗后随着血管再通、各种有效治疗后逐渐恢复正常,因此,甲状腺激素水平可以作为AMI患者心肌功能恢复临床评估指标。     

高血压患者中血浆血脂和甲状腺激素浓度的关系

目的探讨高血压患者中,血浆的血脂水平与甲状腺激素的相关性.方法 129例高血压病患者在空腹状态下抽取血样本,检测其血脂、血糖及甲状腺激素浓度,甲状腺激素测定使用放射免疫测定法检测.结果 Pearson 相关分析显示: 在男性组中,总胆固醇(TC)与反三碘甲状腺原氨酸(rT3)呈显著负相关(r=-0.259,P=0.045),高密度脂蛋白胆固醇(HDL-C)与三碘甲状腺原氨酸(T3)(r=-0.267,P=0.039)、甲状腺素(T4)(r=-0.388,P=0.002)均呈显著负相关.在女性组中,TC(r=0.431,P=0.000)、低密度脂蛋白胆固醇(LDL-C)(r=0.397,P=0.001)均与T3呈显著正相关,HDL-C与rT3呈显著负相关(r=-0.284,P=0.018).均衡性别、年龄、收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、空腹血糖后,偏相关分析结果显示:TC(r=0.2280,P=0.011)、LDL-C(r=0.1961,P=0.028)均与T3有显著正相关性,TC(r=-0.2151,P=0.016)、HDL-C(r=-0.1933,P=0.031)与rT3有显著负相关性.结论在甲状腺功能正常的高血压患者中,甲状腺激素与血脂之间有一定的相关性.     

Stress hormones given to healthy volunteers alter the concentration and configuration of ribosomes in skeletal muscle, reflecting changes in protein synthesis

1. The influence of elevated concentrations of stress hormones on the concentration of ribosomes and the relative proportion of polyribosomes, reflecting protein synthesis in vivo, in human skeletal muscle was investigated. Healthy volunteers were given a 6 h infusion of adrenaline (n = 8), cortisol (n = 8), a triple-hormone combination of adrenaline, cortisol and glucagon (n = 8), or saline (n = 8). 2. The total ribosome concentration declined by 30.4 +/- 7.2% in the triple-hormone group (P less than 0.01), by 26.9 +/- 8.6% in the cortisol group (P less than 0.05) and by 24.8 +/- 11.2% in the adrenaline group (P less than 0.05). The proportion of polyribosomes to total ribosomes decreased by 8.5 +/- 2.2% in the triple-hormone group (P less than 0.05). 3. During hormone infusion the serum glucose levels were enhanced. The insulin concentrations in serum were elevated in the adrenaline group and the triple-hormone group, but not in the cortisol group. Serum insulin decreased in the control group. 4. The results indicate an effect of the combined stress hormone infusion on the total ribosome concentration as well as on the relative abundance of polyribosomes. The single hormones influenced the total ribosome concentration only. The results suggest a critical role for stress hormones in producing the decline in muscle protein synthesis seen after trauma.     

Hormonal changes in brain dead patients

Thirty neurologically impaired (Glasgow Coma Score less than 7) patients were evaluated to determine if changes in serum levels of thyroid hormone, cortisol, insulin, or lactate suggest that replacement therapy is needed before removal of organs for donation. Serum levels of free thyroxine (fT4), thyroid-stimulating hormone (TSH), reverse T3 (rT3), cortisol, insulin, and lactate were monitored in 16 patients before and after brain death and in 14 additional patients who were similarly compromised but did not become brain dead. Low fT3, normal fT4, and normal or high rT3 as found in most patients were consistent with a variant of the euthyroid sick syndrome although TSH was elevated in some patients. Cortisol, insulin, and lactate levels were also normal or high. No correlation was found between low thyroid hormones and elevated lactate or the amount of vasopressor needed to sustain BP. No significant changes occurred in hormone or lactate levels after brain death. The explanation for an elevated lactate remains unclear but we do not believe this single finding justifies the diagnosis of a hypothyroid state in these patients or the administration of thyroid hormone to brain dead organ donors.