妊娠合并甲状腺功能异常187例临床分析

目的探讨妊娠合并甲状腺功能亢进或减退对妊娠结局的影响。方法回顾性分析,1999年至2008年187例妊娠合并甲状腺功能异常患者的妊娠结局及其影响因素。结果妊娠合并甲亢发病率程逐年下降趋势,基本稳定在1‰左右,妊娠合并甲减发病率程逐年上升趋势;妊娠合并甲亢患者,治疗与未治疗产科并发症发生率分别为38．2％与42．9％,妊娠合并甲减患者,治疗与未治疗产科并发症发生率分别为48．9％与71．4％,差异均具有统计学意义。结论对妊娠合并甲状腺功能异常者进行早期筛查、诊断并及时给予治疗,可有效降低不良妊娠结局发生。     

甲状腺功能异常患者心肌酶变化的分析

为了解原发性甲状腺功能减退症（甲减）患者和甲状腺功能亢进（甲亢）患者心肌酶的变化,检测了20例原发性甲减患者、27例甲亢患者以及30例健康体检者（对照组）的空腹血清天门冬酸氨基转移酶（AST）、肌酸激酶（CK）及其同工酶（CK-MB）、乳酸脱氢酶（LDH）及其同工酶（HBDH）、FT3、FT4、TSH、总胆固醇（Tch）。结果显示,原发性甲减患者AST、CK、CK-MB、LDH、HBDH及Tch均明显高于对照组（P分别〈0.01、0.01、0.01、0.01、0.05、0.01）;TSH和FT4与心肌酶、Tch均无相关性;FT3与CK、CK-MB负相关（r=-0.53,-0.47,P均〈0.05）,与Tch呈负相关（r=-0.504,P〈0.05）;甲亢患者血清CK-MB明显高于对照组（P〈0.01）,且血清FT4与CK-MB呈显著正相关（r=0.462,P〈0.01）。结论：原发性甲减患者和甲亢患者常伴心肌酶升高,其中甲减者FT3水平与CK、CK-MB、Tch升高关系更密切。     

甲状腺功能减退与妊娠期血栓前状态的相关分析

目的 探讨甲状腺功能减退对凝血功能的影响,分析甲状腺功能减退与妊娠期血栓前状态的相关性.方法 选取2012年1月至2017年2月我院临床甲状腺功能减退孕妇46例为甲减组,亚临床甲状腺功能减退孕妇39例为亚临床甲减组,随机抽取50例甲状腺功能正常且无合并其他疾病的健康孕妇为对照组,比较3组受试者的甲状腺功能与凝血功能相关指标.结果 与对照组比较,甲减组的促甲状腺激素(TSH)、纤维蛋白(FIB)较高,游离甲状腺素(FT4)、凝血酶原时间(PT)较低,亚临床甲减组TSH较高,PT较低,差异均有统计学意义(P＜0.05).甲减组与亚临床甲减组比较,甲减组FIB较高,差异有统计学意义(P＜0.05).结论 甲状腺功能减退会导致妊娠期血栓前状态,增加患者体内血栓形成的风险,临床上应予重视并给予积极治疗.     

甲状腺功能与血浆BNP的临床相关性研究

目的：B型脑钠肽（BNP）由心室心肌细胞分泌,并对血容量和压力负荷增加做出反应。在充血性心力衰竭时血浆BNP水平升高。本文旨在评估甲状腺的功能状态对血浆BNP水平的影响。方法：选择32例甲状腺功能亢进（甲亢）患者和36例甲状腺功能减退（甲减）患者,采用化学发光免疫分析测定其血浆FT3、FT4、TSH和BNP水平,并与33例正常对照作比较。结果：甲亢患者血浆BNP水平显著高于甲减组以及正常对照组,平均值分别为（203.03±48.61）pg/ml,（48.27±12.53）pg/ml,（57.96±13.59）pg/ml（P〈0.01）。血浆BNP水平与甲状腺的功能状态有显著的相关性（与FT4比较：r=0.625,P〈0.01,n=32）。多重线性回归分析提示FT3、FT4的值与BNP的水平具有独立相关性。结论：血浆BNP的水平受甲状腺的功能状态影响,这一点可能源于甲状腺激素是BNP的直接刺激物。     

原发性甲状腺功能减退与肾功能的相关性分析

目的:探讨原发性甲状腺功能减退症(原发性甲减)患者甲状腺功能与肾功能的关系.方法:检测68例原发性甲减患者和50例正常对照组的空腹血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、高敏促甲状腺激素(hs-TSH)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、肌酐清除率(CCr)、尿蛋白定性,并进行相关性分析.结果:原发性甲减患者BUN、Cr、UA、尿蛋白阳性率均明显高于正常对照组,而CCr明显低于正常对照组,并且FT3与CCr呈正相关(r=0.682,P<0.05),与UA呈负相关(r=-0.415,P<0.05).结论:提示原发性甲减患者常伴BUN、Cr、UA、尿蛋白阳性率升高,CCr下降;血清hs-TSH、FT4与肾功能无明显相关性,而CCr水平下降与FT3密切相关.     

绝经前后亚临床甲减患者骨密度变化的临床分析

目的 探讨绝经前后女性亚临床甲状腺功能减退症(亚临床甲减)患者骨密度(BMD)的变化.方法 选择我科就诊亚临床甲减女性患者110例,分为绝经前和绝经后两组,按亚临床甲减病程长短又分为短病程和长病程两个亚组,记录各组年龄、体重指数(BMI)、促甲状腺激素(TSH)、血钙、血磷、绝经年限及BMD.结果 在绝经前、后亚临床甲减患者中,亚临床甲减病程长者腰椎L2-4、左股骨颈及股骨大转子BMD明显低于病程短者(P＜0.05).Spearman相关性分析结果表明,BMD与年龄、BMI、TSH、绝经年限、亚临床甲减病程呈明显负相关.Logistic回归分析显示TSH、亚临床甲减病程、绝经年限是骨质疏松的独立危险因素.结论 亚临床甲减病程的长短及绝经与否是女性亚临床甲减患者骨密度的重要影响因素.     

血清鸢尾素在妊娠期甲状腺功能减退症诊断中的价值

目的:分析血清鸢尾素在妊娠期甲状腺功能减退症(以下简称甲减)诊断中的价值,为妊娠期甲减的诊断筛查工作提供依据.方法:选取120例妊娠期甲减患者作为病例组,选取同期100名接受产检的健康孕妇作为对照组.对两组患者的一般资料、血清促甲状腺激素(thyroid stimulating hormone,TSH)、游离甲状腺素(...     

不同出生体重儿的甲状腺功能检测及分析

目的探讨不同出生体重新生儿的甲状腺功能。方法将盐城市第三人民医院2003年2月~2006年12月收治的不同出生体重的新生儿120例分成4组:A组(出生体重1100g~1499g n1=30),B组(出生体重1500g~1999g n2=30),C组(出生体重2000g~2499g n3=30),D组(出生体重2500g~3750g n4=30),采用放免法测定不同出生体重新生儿出生后第1天及第10天血清FT3、FT4及TSH水平。结果各组血清FT3、FT4、TSH生后1~10天均成下降趋势,FT3、FT4的水平与出生体重成正相关,C组、D组生后第1,10天血清FT3、FT4明显高于A组、B组,B组明显高于A组,C组与D组之间差异无显著性;生后第1天TSH水平C组、D组>A组、B组,生后第10天血清TSH A组、B组>C组、D组,C组与D组之间差异无显著性。结论新生儿的甲状腺功能与出生体重成正相关,出生体重低于1999g的新生儿存在甲状腺功能的暂时性低下。     

甲状腺功能亢进症的药物应用分析

目的 分析不同用药方案对甲状腺功能亢进症患者的应用效果.方法 选择2009年9月～2010年9月我科收治的甲状腺功能亢进症患者56例,随机分为2组:对照组和实验组.对照组:给予丙硫氧嘧啶300 mg,3次/d,据甲状腺激素水平逐渐减量至25～100 mg/d;实验组:给予甲巯咪唑30mg/d,3次/d,据甲状腺激素水平逐渐减量至2.5～10 mg/d.6个月后比较2组患者的临床疗效.结果 实验组患者的总有效率明显高于对照组(P＜0.05).结论 甲巯咪唑对甲状腺轻、中度肿大的甲亢患者疗效优于丙硫氧嘧啶.     

Correlations of circulating peptide YY and ghrelin with body weight,rate of weight gain,and time required to achieve the recommended daily intake in preterm infants

The objective was to elucidate the relationships between serum concentrations of the gut hormone peptide YY (PYY) and ghrelin and growth development in infants for potential application to the clinical observation index. Serum concentrations of PYY and ghrelin were measured using radioimmunoassay from samples collected at the clinic. For each patient, gestational age, birth weight, time required to return to birth weight, rate of weight gain, time required to achieve recommended daily intake (RDI) standards, time required for full-gastric feeding, duration of hospitalization, and time of administration of total parenteral nutrition were recorded. Serum PYY and ghrelin concentrations were significantly higher in the preterm group (N = 20) than in the full-term group (N = 20; P < 0.01). Within the preterm infant group, the serum concentrations of PYY and ghrelin on postnatal day (PND) 7 (ghrelin = 1485.38 ± 409.24; PYY = 812.37 ± 153.77 ng/L) were significantly higher than on PND 1 (ghrelin = 956.85 ± 223.09; PYY = 545.27 ± 204.51 ng/L) or PND 3 (ghrelin = 1108.44 ± 351.36; PYY = 628.96 ± 235.63 ng/L; P < 0.01). Both serum PYY and ghrelin concentrations were negatively correlated with body weight, and the degree of correlation varied with age. Serum ghrelin concentration correlated negatively with birth weight and positively with the time required to achieve RDI (P < 0.05). In conclusion, serum PYY and ghrelin concentrations reflect a negative energy balance, predict postnatal growth, and enable compensation. Further studies are required to elucidate the precise concentration and roles of PYY and ghrelin in newborns and to determine the usefulness of measuring these hormones in clinical practice.     

佛山地区妊娠中、晚期妇女甲状腺疾病特点的研究

目的探讨佛山地区妊娠中、晚期妇女甲状腺疾病的特点。方法选择佛山地区妊娠中期（孕16～24周）孕妇222例为中孕组,妊娠晚期（孕37～41^＋6周）孕妇113例为晚孕组,另选择同期在本院进行健康体检的非妊娠育龄妇女为非孕妇组,共204例,应用电化学发光免疫检测技术检测血中游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及促甲状腺激素（TSH）的值。按如下标准确定诊断：TSH〈0．34mlU／ml,FT3和／或FT4升高者,诊断为甲状腺功能亢进（甲亢）;TSH〈0．34mlU／ml,m和b-T4正常者诊断为亚临床甲亢;TSH〉4．8mlU／ml,FT3和／或FT4降低者诊断为甲状腺功能减退（甲减）,TSH〉4．8mlU／ml,FT3和FT4正常者诊断为亚临床甲减。结果①比较甲状腺疾病患病率,中孕组与非孕妇组比较,P〉0．05,差异无统计学意义,晚孕组分别与中孕组及非孕妇组比较,P〈0．05,差异有统计学意义,晚孕组的甲状腺疾病患病率明显高于中孕组及非孕妇组。②比较甲状腺疾病的类型,各组的甲状腺疾病类型不同。组内甲亢（含亚临床甲亢）与甲减（含亚临床甲减）的患病率比较,在非孕妇组中,P〉0．05,差异无统计学意义;中孕组中,P〈0.05,差异有统计学意义,甲亢患病率明显高于甲减;晚孕组中,P〈0．05,差异有统计学意义,甲亢患病率明显高于甲减。③组间比较甲亢与甲减患病率,中孕组与晚孕组比较,P〉0．05,差异无统计学意义;中孕组与非孕妇组比较,P〉0．05,差异无统计学意义;晚孕组与非孕妇组比较甲亢患病率,P〈0．05,差异有统计学意义,晚孕组甲亢的患病率明显高于非孕妇组,比较甲减患病率,P〉0．05,差异无统计学意义。结论沿海城市孕中晚期妇女甲状腺疾病的类型以甲亢为主,建议通过孕中期开始定期检测甲状腺功能,及时发?     

The correlation between self-reported and measured height,weight, and BMI in reproductive age women

This prospective, cross-sectional study of 60 women compares self-reported height, weight, and BMI with measured values. Self-reported BMI (29.0 ± 8.37 kg/m²) was slightly lower than measured BMI (29.1 ± 8.38 kg/m²) (p = 0.4). Eighty percent of participants reported a BMI in the same category in which their BMI was measured. Pearson's correlation coefficient for height (0.96, p < 0.001), weight (0.99, p < 0.001), and BMI (0.99, p < 0.001) were high. Reproductive age women accurately reported their height and weight.     

Difference in the effects of body composition on bone mineral density between pre- and postmenopausal women

Objective: This study was to investigate whether the effect of lean and fat mass component on bone mineral density (BMD) differs between pre- and postmenopausal women. Materials and methods: Subjects were 360 pre- and 193 postmenopausal Japanese women with right side dominance. Age, height, and years since menopause (YSM, in postmenopausal women) were recorded. Body fat and lean body mass were measured by whole body scanning with dual-energy X-ray absorptiometry (DEXA). BMD of the vertical axis (L2-4 of the lumbar spine, pelvis, bilateral legs, and total body) and horizontal axis (arms) were also measured by DEXA. Results: In premenopausal women, lean body mass was independently correlated with BMD of the left arm (partial correlation COEFFICIENT=0.417), right arm (0.430), L2-4 (0.285), pelvis (0.276), left leg (0.403), right leg (0.412), and total body (0.377) (P<0.001). However, body fat mass was not correlated with several BMD sites except for pelvis BMD (0.187, P<0.01). In postmenopausal women, body fat mass was independently correlated with BMD of the left arm (0.248, P<0.01), L2-4 (0.188, P<0.05), pelvis (0.263, P<0.01), left leg (0.228, P<0.01), right leg (0.319, P<0.001), and total body (0.188, P<0.01)). However, lean body mass was correlated with BMD in only three segmental regions including left arm (0.175), right arm (0.217), and left leg (0.210; P<0.05). Conclusion: Lean body mass is a significant determinant of BMD in premenopausal women, while body fat mass is a significant determinant in postmenopausal women.     

单纯性肥胖症患者外周血Obestatin、Ghrelin与胰岛素抵抗的关系

目的:探讨单纯性肥胖症患者外周血肥胖抑制素Obestatin、Ghrelin的变化以及与胰岛素抵抗(Insulin resistance,IR)的关系.方法:选取我校2017、2018级学生为研究对象,分为体质指数(Body mass index,BMI)≥28㎏?m-2的单纯性肥胖症组(n=30)和正常对照组(n=2...     

Ghrelin、melanotan-Ⅱ以及胆囊收缩素对下丘脑双侧室旁核损伤大鼠摄食的影响

目的探讨大鼠下丘脑双侧室旁核(PVN)损伤引起的过食和肥胖的产生机制。方法 Wistar雄性大鼠36只,通过电损伤下丘脑双侧PVN使大鼠产生过食和肥胖,检测ghrelin、melanotan-II(MT-II,一种合成的α-黑色素细胞刺激素——α-MSH的结构同源体)以及胆囊收缩素-8(CCK-8)摄食作用的改变。结果双侧PVN损伤后大鼠的体重和摄食量明显增加,显示出过食和肥胖,手术后1周,外周给与Ghrelin,3～4h后PVN损伤组比伪损伤组的摄食量增加明显,Ghrelin显示出更强的刺激摄食的作用;中枢给予MT-Ⅱ可明显抑制24h节食大鼠的食物摄取,然而PVN损伤后MT-II对24h节食大鼠摄食的抑制作用减弱甚至消失;外周给予CCK-8可明显抑制大鼠各时间段的摄食作用,PVN损伤组和伪损伤组之间未见明显差异。结论大鼠下丘脑双侧PVN损伤引起的过食和肥胖可能与增强的ghrelin对摄食的刺激作用和(或)α-MSH受体的破坏有关。     

The orexigenic effect of peripheral ghrelin differs between rats of different age and with different baseline food intake, and it may in part be mediated by the area postrema

Ghrelin is mainly secreted during fasting. While an orexigenic effect of peripherally injected ghrelin has been reported, reproducing this effect has often proven difficult. Here, we hypothesized that ghrelin's effect to increase food intake may depend on the experimental conditions (e.g., age of animals). We therefore investigated the effect of an IP ghrelin injection (100 microg/kg) on food intake in rats of different age and at different times during the light-dark cycle, i.e. with different levels of baseline food intake. Ghrelin injected at dark onset in ad libitum fed young rats (body weight [BW] 92 g) slightly increased feeding while no such effect was observed in 12 h food deprived rats (BW 150 g). In the middle of the light phase, ghrelin significantly increased feeding up to 2 h after injection in ad libitum fed rats (BW 130 g; food intake 1 h after injection: NaCl 0.4 +/- 0.2 g versus ghrelin 1.2 +/- 0.3 g [p < 0.05]). In various subsequent experiments, older rats (BW 300-490 g) tested under the same conditions did not respond to a single ghrelin injection. However repeated ghrelin injection (15 microg/kg/day once daily at light onset) over 10 days significantly increased food intake in rats (BW 400-460 g) starting from day 4 of the experiment (24 h food intake: NaCl approx. 19.5 g, ghrelin 22.5 g). Interestingly, the latter effect was completely abolished in rats lesioned in the area postrema (AP). Cumulative food intake was also increased in SHAM but not in AP-X animals (e.g., after 7 days: SHAM/NaCl 135.1 +/- 5.3 g versus SHAM/ghrelin 149.7 +/- 3.5 g [p < 0.05], AP-X/NaCl 127.2 +/- 16.4 versus AP-X/ghrelin 127.9 +/- 5.3). We conclude that ghrelin's effect to increase food intake can best be demonstrated when basal food intake is low. Ghrelin increases feeding mainly in young, fast growing animals. Ghrelin may therefore link the high energy needs to body growth in young individuals. In older animals, peripheral ghrelin increased feeding when injected repeatedly over several days. At least under these conditions, ghrelin's effect was mediated by the AP/NTS region. Using repeated administration, ghrelin might be an interesting tool to increase feeding in patients suffering from wasting diseases such as cancer anorexia.     

甲亢患者病程及血清T_3、T_4水平对脑电功率谱的影响

目的：对甲亢患者进行脑电功率谱的定量研究以观察甲亢对脑功能的影响。方法：采用计算机分析技术检测患者脑电功率谱，并测定血清Ｔ３、Ｔ４水平，结合病程综合研究。结果：甲亢患者脑电θ相对功率和（δ＋θ）／（α＋β）比值较正常对照组显著增高，α１＋α２较正常对照组显著降低；抗甲状腺药物治疗１个月后患者血清Ｔ３、Ｔ４恢复正常，但θ频段相对功率仍高于正常；甲亢患者的病程长短和血清Ｔ３、Ｔ４水平的增高与脑电功率谱的异常有密切关系。结论：长期的高甲状腺素水平可致脑机能损害；脑电功率谱可定量显示甲亢病人脑机能损害程度     

The influence of increased training volume on cytokines and ghrelin concentration in college level male rowers

The aim of this study was to investigate plasma IL-6, TNF-α, leptin and ghrelin concentrations during high-volume training. Eight trained male rowers participated. Fasting blood was sampled before (T1) and after (T2) increased training volume and after recovery period (T3). Two-hour rowing was performed at T1, T2 and at T3 with blood samples before, POST and POST 30′. Decrease in fasting leptin was observed at T2 (from 1.31 (0.53) to 0.93 (0.27) ng ml⁻¹; P < 0.05). Leptin was also significantly decreased at POST and POST 30 exercise compared to PRE test at T2. At T2 POST 30′ leptin was significantly lower compared to corresponding value at T1. There were no significant post-exercise changes in ghrelin at T2 compared to T1 and T3. TNF-α was significantly increased POST exercise only at T2. In conclusion, high-volume training causes alterations of post exercise leptin and TNF-α, while increases in ghrelin are down regulated.     

Cognitive dietary restraint: impact on bone, menstrual and metabolic status in young women

We compared bone mineral density (BMD) and content (BMC), menstrual and metabolic status between physically active women with 1) high cognitive dietary restraint (High-CDR) (score>/=9, n=38) and Normal-CDR (score<9, n=46) and 2) across quartiles of CDR scores. Eighty-four physically active (500+/-35 min wk(-1)) premenopausal women participated and were categorized according to their CDR score. Primary outcomes included, BMD, BMC, menstrual status, estrone-3-glucuronide (E1G) and pregnanediol-3-glucuronide (PdG) area under the curve (AUC). Secondary outcomes included resting energy expenditure (REE), total triiodothyronine, and ghrelin. Measures of body mass (59.2+/-1.1 vs. 58.5+/-1.0 kg) and percent body fat (24.7+/-1.2 vs. 23.7+/-0.7%) were similar between women with Normal-CDR and High-CDR, however the High-CDR group had lower total body (1.140+/-0.011 vs. 1.179+/-0.010 g cm(-2); p=0.015) and lumbar spine (1.114+/-0.019 vs. 1.223+/-0.022 g cm(-2); p=0.001) BMD. The prevalence of oligo-amenorrhea was higher in the High-CDR group and became increasingly greater across the CDR quartiles. There were no differences in metabolic characteristics between the High-CDR and Normal-CDR groups, however REE and the ratio of measured to predicted REE were lower in the fourth quartile (CDR scores>/=13) compared to the second and third quartiles. Our results provide evidence that high CDR scores are associated with reduced lumbar spine and total body BMD in physically active premenopausal women. A greater frequency of menstrual disturbances in women with higher CDR scores likely played a role in the reduced total body and lumbar spine BMD.