地方性甲状腺肿患者甲状腺吸^131碘机能分析

检测240例地方性甲状腺肿患者(简称甲肿者)及无甲状腺肿大者(简称无甲肿者)甲状腺吸~(131)碘(RAIU)结果表明,缺碘甲肿者、无甲肿者 RAIU 均显著高于对照组(P<0.01),并呈碘饥饿状态,提示缺碘人群都是碘缺乏者;缺碘甲肿者 RAIU 增高程度与甲肿程度呈正相关。高碘甲肿者、无甲肿者 RAIU 均低于对照组(P<0.01),表明高碘区人群无论甲肿与否同属碘过剩者;高碘人群中26.6%出现 RAIU 高峰前移,甲肿者尤为明显(34.9%)。     

河南省黄河冲积平原水源性高碘甲状腺肿流行病学调查

目的 掌握河南省水源性高碘地区分布和高碘甲状腺肿流行情况，更好地落实防治措施。方法 以乡为单位进行全省外环境水碘基线调查；对全省原碘缺乏病非病区进行流行病学抽样调查。结果 发现位于豫东黄河冲积平原的18个县(市、区)水碘较高，在测定的5023份水样中，水碘值在150μg／L以上的占47．6％；高碘水源呈片状分布，呈乡与乡、县与县连在一起；高碘地区和适碘地区并存。碘的摄入量与甲状腺肿的流行存在明显的剂量-效应关系，学龄儿童的甲状腺肿大率随水碘的升高而升高。结论 河南省豫东黄河冲积平原18个县(市、区)所辖的164个乡为水源性高碘地区和高碘病区，存在高碘甲状腺肿的地方性流行。     

砀山县儿童高碘甲状腺肿初探

目的 探讨砀山县补碘前儿童碘营养状况。方法 按不同地理位置抽取3个乡(镇)，每个乡(镇)抽取一所小学，每所小学抽取l0岁儿童40名，调查儿童尿碘、甲状腺肿大率和TSH。结果 儿童尿碘中位数727．35μg/L，尿碘超过800μg/L的占43．3％，最高达到l348．4lμg/L，儿童甲状腺肿大率触诊法和B超声法分别为17．5％和16．8％，TSH均值1．39mU/L，大于5．0mU/L仅占1．01％。结论 该县儿童甲状腺肿是由摄入的碘量过多引起，存在高碘地方性甲状腺肿。     

山东内陆高碘地方性甲状腺肿流行病学特点

对内陆地区梁山，嘉祥、单县、巨野四个县水含碘量（３４７～１ ３８０μｇ／ｌ）高的１３个村，进行流行病学调查。发现８ ００４名居民中，甲状腺患病率和肿大率分别为１１．５６％和３９．６６％，女性高于男性。男性７～２５岁和女性７～３０岁是高发人群。血清Ｔ３、Ｔ４、ＴＳＨ、ＴＭＡｂ、ＴＧＡｂ大都在正常范围。尿碘为１ ０３２．９７±１．７７μｇ／ｌ。土、粮、菜含碘量与水碘没有规律性关系。结果证实山东内陆地区     

天津市食盐加碘后甲状腺肿大率与碘营养状况的调查

目的：调查和研究食盐加碘后天津市居民的甲状腺肿大率和碘营养状况,方法：在6个区共调查居民31530人,7－14岁在校儿童4415人,对调查对象进行甲状腺肿大率,尿碘浓度,食盐碘含量等项目的调查。结果：（1）食盐加碘后天津市居民的平均甲状腺肿大率为5．5％,8－10岁儿童平均甲状腺肿大率为19．7％,甲状腺肿大率较食盐加碘以前有了明显下降,但下降的速度较缓慢,（2）天津市食盐加碘以后各区居民的平均尿碘中位数为287．2ug/L,各区儿童尿碘中位数平均为271．6u/L,证明总体人群碘营养充足,（3）天津市居民总体盐碘含量超过20mg/kg水平,各区居民户盐含碘量有9．9％－41．1％超过60mg/kg,说明碘盐的含碘是偏高是一个新的现象。结论：经过3年左右的食盐加碘防治工作,天津市碘缺乏情况已得到控制。     

高碘地方性甲状腺肿研究进展(之一)

１９８０年,我国在河北省渤海湾海滨发现了高碘地方性甲状腺肿［１］,１９８３年,于志恒在高碘甲状腺肿综述中作了较系统的论述［２］。此后十几年来,在这个病的流行范围、临床与化验室检查、并发疾病、发病机理以及高碘对儿童智力影响等方面已取得重要进展。现根据国内外主要文献进行综述。１　流行病学１１　国内：１９８３年之前,我国高碘地方性甲状腺肿（以下简称高碘地甲）仅见于河北与山东省的渤海湾海滨和新疆自治区的奎屯乌苏山前倾斜地带,其流行情况,在高碘甲状腺肿综述中已作了叙述。１９８３年,河北省在较大范围内进行…     

高碘地区与地方性高碘甲状腺肿

概念１．１高碘病区人群的尿碘水平在８００μｇ／Ｌ以上，水碘水平在３００μｇ／Ｌ以上以及儿童的甲状腺肿大率大于５％的地区称为高碘病区。而尿碘和水碘处于较高水平，目前尚无甲状腺肿流行，但供应碘盐后将会或可能造成高碘甲状腺肿流行的地区，称为高碘地区。１．２...     

实验性高碘和低碘甲状腺肿的对比研究

在同一实验室用高碘和低碘饲料对同一种动物成功地诱发了高碘和低甲状腺肿。甲状腺肿发生率,低碘组84.21%,高碘组88.88%,对照组0.00%。实验证明,高碘和低碘甲状腺肿在形态、功能等方面存在着明显地差异。因此,作者认为,高碘甲状腺肿的发病机理可能与低碘甲状腺肿不同。     

全民食盐加碘4年来我国是否发生了高碘性甲状腺肿流行

我国大部分省区自 1995年开始陆续施行了全民食盐加碘 ,截至 1999年共 4年时间。根据 1995— 1999年 3次全国碘缺乏病监测结果 [1～ 3 ]表明 ,我国人民的碘营养水平得到了明显提高。除新疆、西藏等西部少数省区外 ,绝大多数省区原有不同程度的碘缺乏均得到了彻底纠正。从全国水平看 ,随着碘盐覆盖率及合格碘盐食用率逐年提高 ,儿童尿碘中位数自1997年起持续维持在 30 0 μg/ L,儿童甲肿率及触诊法 2度肿大率均逐年下降。但甲肿率仍未降至国际组织推荐标准 (≤5 % )。人们不禁要问 ,我国施行全民补碘 4年来 ,甲肿率仍未达到标准 ,其原因是什…     

江滩型地区洪灾与血吸虫病流行关系的研究

目的：探讨江滩型地区洪灾与血吸虫病流行的关系。方法：通过螺情,病情的气象水文资料收集进行综合分析。结果：试区1998年和1999年遭受特大洪灾,年降雨量分别为1756．9mm和2263．1mm,江滩新增钉螺面积16．50万m^2,汛后人群血吸虫感染率,感染度显著增高。结论：洪灾造成钉螺扩散,加重血吸虫病的传播。     

THYROID IODINE CONCENTRATION AND TOTAL THYROID IODINE IN NORMAL SUBJECTS AND IN ENDEMIC GOITRE SUBJECTS

Thyroid iodine concentration and total thyroid iodine were determined by an automated technique by means of the eerie arsenious acid reaction in 42 males and 13 females. The thyroids were taken from autopsy material in a region with a low dietary intake. The accuracy of the method to estimate iodine was checked by neutron activation analysis. There was an excellent correlation between the iodine contents of thyroid specimens, when measured by chemical or by activation analysis. The mean iodine concentration was 1.86 mg/g dry weight and was found to be lower than in non-goitrous regions. In goitres, the mean iodine concentration was significantly lower, and the mean total thyroid iodine was significantly higher, when compared with the data of thyroids of normal weight. There was no significant difference in iodine concentration and total iodine between males and females. The thyroid iodine concentration did not depend upon age in adults. The data were log normally distributed. It was established that mean iodine concentrations under 2 mg/g dry weight or 0.45 mg/g fresh weight are to be regarded as an important index of iodine deficiency.     

太原市郊区内陆高碘地方性甲状腺肿患者的调查及其免疫学改变

对浅井饮用水含碘量462.5μg/L的高家堡村之120例中、小学生进行调查,甲状腺总肿大率为65％,生长发育、神经学及智力检查均正常,无明显甲亢或甲低之临床表现;但血清TSH增高,FT_4增高,T_3低,说明有亚临床甲状腺功能减低之倾向。血清免疫球蛋白测定中发现甲状腺刺激免疫球蛋白(TGI)强阳性者占75％,而标志慢性淋巴细胞性甲状腺炎之TGA、TMA之阳性率却很低。     

水源高碘地方性甲状腺肿并发甲状腺机能亢进的研究

本文报告“水源高碘地方性甲状腺肿并发甲状腺机能亢进”(以下简称水源高碘甲肿甲亢),在高碘地甲肿患者中检出率高达7.76%。临床上有甲状腺Ⅱ°—Ⅲ°弥漫性肿大,有典型甲亢的症状和体征。甲状腺吸~(131)碘率较当地居民明显增高,血清 T_3、T_4偏高,但 TSH 基本正常,有的甚至偏低,T_3抑制试验不抑制,有的 TGAb、TMAb 为阳性,有的 TPO (过氧化物酶活性)增高。病理检查:具有巨滤泡性胶样甲状腺肿和甲状腺机能亢进两组病理学和超微结构特征。     

碘缺乏与碘过多对大鼠甲肿形成及功能的影响

目的：研究碘缺乏与碘过多对大鼠甲状腺肿形成及其功能的影响。方法：实验分为三组，适碘组（对照组）、低碘组、高碘组，观察甲状腺及垂体重量，甲状腺组织及尿激的碘含量，血清及甲状腺组织激素水平。结果：低碘组甲状腺及垂体重量明显高于对照组，血清Ｔ４及组织Ｔ３、Ｔ４、组织及尿碘含量均明显低于对照组，血清Ｔ３在１２周时代偿性增高，２４周时明显下降。高碘组甲状腺及垂体重量，血清Ｔ４及组织碘含量无明显改变，尿碘明显     

RELATIONSHIP BETWEEN SERUM THYROGLOBULIN AND INTRATHYROIDAL STABLE IODINE IN HUMAN SIMPLE GOITRE

Serum thyroglobulin levels are increased in many patients with simple goitre. This increase has been attributed to the release of thyroglobulin (Tg) from the colloid of necrosed follicles. To test the hypothesis that increased serum Tg could be related to the low intrathyroidal iodine concentration [I], the main cause of nontoxic goitre, these two variables were measured in 91 euthyroid goitrous patients and compared to serum free T3 and free T4 levels as well as thyroid weight. Thyroid iodine concentration was estimated from the X-ray fluorescence measurement of intrathyroidal iodine stores and from the weight of the gland estimated by planimetry. Serum Tg levels, the free T3/T4 ratio and thyroid weight were negatively correlated to [I] (Spearman's coefficient of correlation = - 0.44 (P = 0.001); -0.30 (P = 0.006); -0.33 (P = 0.001), respectively). Tg levels were also positively correlated to the T3/T4 ratio (R = 0.28, P = 0.008) and to the weight of the gland (R = 0.37; P = 0.001). These data suggest that, in simple goitre, increased serum Tg concentrations are partly related to the reduced concentration of iodine in goitre tissue (as are an increased T3/T4 ratio and the size of the goitre) and is not only the reflection of follicular necrosis.     

DIFFERENTIAL EFFECTS OF OVINE AND HUMAN CORTICOTROPHIN-RELEASING FACTOR IN HUMAN SUBJECTS

Ten healthy subjects received 200 micrograms of human CRF (hCRF) and 200 micrograms of ovine CRF (oCRF) as an intravenous bolus injection on two different occasions. After hCRF plasma ACTH levels rose significantly (P less than 0.0005, by Friedman's nonparametric analysis of variance) from a basal value of 35 +/- 3 pg/ml (mean +/- SEM) to a peak value of 80 +/- 7 pg/ml 30 min after hCRF administration. This ACTH response was followed by a rise in plasma cortisol levels (P less than 0.0005, by Friedman's test) from a baseline value of 0.32 +/- 0.03 mumol/l to a peak value of 0.56 +/- 0.02 mumol/l 60 min after hCRF. Ovine CRF elicited similar rises in the plasma ACTH and cortisol levels. However, as derived from the faster rate of decline of ACTH and cortisol after hCRF than after oCRF, human CRF had a significantly shorter duration of action than ovine CRF in humans. Human CRF not only stimulated ACTH release by the human pituitary gland but also prolactin release. After hCRF administration prolactin levels rose significantly (P less than 0.005, by Friedman's test) from a basal value of 179 +/- 18 mU/l to a peak value of 288 +/- 34 mU/l at 10 min.     

冀中平原水源型高碘甲状腺肿改水降碘防治研究

本文对水源性高碘甲状腺肿选两村对比观察了居民甲肿患病率,7～14岁青少年甲肿率及尿碘,甲状腺吸~(131)碘率。肯定了改水降碘的防治效果。并排除水质和其它条件的影响。证实居民尿碘和甲状腺24小时吸~(131)碘率可作为防治效果的参考指标。     

多发性脑梗塞患者智能障碍与病变关系的研究

１９９１～１９９２年间收集了由ＣＴ证实有２个以上脑梗塞病灶的患者２４０例，作系列神经心理学量表检查，其中４２．９２％有智能障碍。对比分析智能障碍发生与否与病史、脑梗塞灶的定位、体积、是否伴发皮层萎缩或皮层下变性影像学检查结果的关系。采用多元回归和因子分析等统计学方法，提示梗塞灶病变在智能障碍的发生中并不居首要地位，因此建议以缺血性或血管性痴呆取代通常称为多梗塞性痴呆。