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     

甲状腺功能异常对血清瘦素水平的影响

为研究甲状腺功能低下和甲状腺功能亢进时甲状腺素对血清瘦素(leptin)水平的影响,检测15例甲状腺功能低下患儿和10例甲状腺功能亢进患儿治疗前后血清leptin、T_3、T_4、TSH和体块指数(BMI),同期检测10例正常儿童的上述各项指标。结果:①甲低组、甲亢组和正常对照组中,leptin与BMI均有相关性(P<0.05),相关系数分别为0.49、0.46、0.63。②在年龄、性别和BMI均相匹配的情况下,甲低组治疗前leptin水平(0.64ng/ml±0.39ng/ml)显著低于甲亢组(2.51ng/ml±1.5ng/ml)和正常对照组(2.06ng/ml±1.07ng/ml),P<0.05;用左旋甲状腺素片治疗使甲状腺功能恢复到正常后。血清leptin浓度升高(2.67ng/ml±2.01ng/ml),达到正常水平;甲亢组治疗前leptin水平(2.51ng/ml±1.5ng/ml)与治疗后(2.32ng/ml±0.74ng/ml)、正常对照组(2.06ng/ml±1.07ng/ml)相比,均无明显差别(P>0.05)。结果表明,甲状腺素对血清leptin的分泌起一定的促进作用。     

儿童甲状腺功能亢进症的治疗

甲状腺功能亢进症（简称甲亢）是由于甲状腺激素（ＴＨ）分泌过多，导致全身各系统代谢率增高的一组综合征。引起儿童时期甲亢的最主要病因是弥漫性毒性甲状腺肿（又称Ｇｒａｖｅｓ病），是一种器官特异性自身免疫性疾病，为自身免疫性甲状腺疾病中的一种。其发病多是在具...     

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     

内分泌系统疾病

05 1 773　人钠 /碘转运体 3 5 4位点基因突变与先天性甲状腺功能减退症的相关性研究 /赵　真…∥中华儿科杂志 .-2 0 0 4,42 (6) .-45 6～ 45 7对 47例先天性甲状腺功能减退症 (CH)患儿 1 0 0名正常对照的外周血 DNA样本进行检测 ,均未发现 h NIS基因 T3 5 4P突变。遗传因素导致的 CH与多种基因的突变有关 ,TG、TPO、TSH基因的异常均在 CH的发生中扮演重要角色。参 1 0 (李　军 )0 5 1 774　儿童与成人格雷夫斯病的临床比较 /袁　琳…∥中国实用儿科杂志 .-2 0 0 4,1 9(6) .-3 67～ 3 685 2例儿童格雷夫斯病性甲亢 (Graves' 病 )…     

血浆内皮素在小儿内分泌疾病中的变化

内皮素(ET)不仅有调节心血管系统的作用,而且参与神经内分泌调节。为此我们观察了5例甲状腺功能亢进患儿,26例甲状腺功能减退患儿,11例单纯性甲状腺肿患儿及13例垂体性侏儒症患儿血清ET的变化。 对象与方法 一、对象 (1)甲减组:26例,男7例,女19例,年龄4 1/2～13岁,根据临床表现,血清FT_3、FT_4减低,TSH升高而确诊。(2)甲亢组:5例。男1例,女4例,年龄6～13岁,根据临床表现,血清FT_3、FT_4升高,TSH降低而确诊。(3)单纯性甲状腺肿组:11     

妊娠期甲状腺疾病对母亲和子代的影响

甲状腺疾病常见于育龄期妇女,约1.2‰的妊娠妇女可能受累,这与妊娠期机体免疫状态改变、自身抗甲状腺抗体产生增加、碘相对缺乏、甲状腺激素代谢改变及绒毛膜促性腺激素(HCG)对促甲状腺激素(TSH)受体的刺激等有关。妊娠期甲状腺疾病如处理不当,甲状腺功能紊乱能显著影响妊娠及产后期,对母亲和子代的健康造成不良影响[1,2]。一、甲状腺功能亢进症(甲亢)(一)妊娠期一过性高甲状腺素血症此症是妊娠期甲亢最常见的原因,一般发生率为2%~3%,最高发生率报告为11%[3]。引起妊娠期一过性高甲状腺素血症的原因主要是TSH与HCG结构同源,它们有相同…     

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leptin水平检测及治疗观察

临床资料 :本文甲状腺功能异常者均为我科 1998年 8月至 2 0 0 0年 7月的门诊患儿 ,临床症状、体征和实验室检查均符合甲状腺功能低下 (甲低 )或甲状腺功能亢进 (甲亢 )诊断 ,首诊时未经任何治疗。甲低组 15例 ,男 5例 ,女10例 ,平均年龄 (5 93± 2 5 6 )岁 ,其中先天性甲低 9例 ,桥本甲状腺炎 6例。甲亢组 10例 ,男 4例 ,女 6例 ,平均年龄 (7 17± 2 71)岁 ,均为Ｇｒａｖｅ’ｓ病。正常对照组 10例 ,男 4例 ,女 6例 ,平均年龄 (6 33± 1 97)岁。三组性别、年龄、体重指数 (ＢＭＩ)相匹配 (Ｐ >0 0 5 ) ,均无肝、肾和其他内分泌代谢疾…     

新生儿高促甲状腺激素血症临床转归分析

目的探讨新生儿高促甲状腺素血症(HT)的临床转归。方法定期随访高促甲状腺激素(TSH)血症患儿,评估其生长发育指标和甲状腺功能及治疗效果。结果新生儿筛查血清TSH 5.6~10 m U/L的191例患儿随访至24个月;182例血TSH逐渐恢复正常,5例血TSH逐渐升高10 m U/L,予以左甲状腺素钠治疗,4例随访2年后血TSH值仍波动在5.6~10 m U/L,继续随访中;血清TSH在10~20 m U/L的44例患儿,予以左甲状腺素钠治疗后38例血TSH值逐渐恢复正常;7例血TSH20 m U/L患儿需持续左甲状腺素钠治疗。242例HT新生儿中共有18例持续服用左甲状腺素钠替代治疗2年,继续随访。结论大多数新生儿HT随年龄增长逐渐恢复正常,有少部分患儿出现甲状腺功能异常,应积极随访。     

Pubertal growth and development and prenatal and lactational exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene

OBJECTIVES: Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) are ubiquitous toxic environmental contaminants. Prenatal and early life exposures affect pubertal events in experimental animals. We studied whether prenatal or lactational exposures to background levels of PCBs or DDE were associated with altered pubertal growth and development in humans.Study design: Follow-up of 594 children from an existing North Carolina cohort whose prenatal and lactational exposures had previously been measured. Height, weight, and stage of pubertal development were assessed through annual mail questionnaires. RESULTS: Height of boys at puberty increased with transplacental exposure to DDE, as did weight adjusted for height; adjusted means for those with the highest exposures (maternal concentration 4+ ppm fat) were 6.3 cm taller and 6.9 kg larger than those with the lowest (0 to 1 ppm). There was no effect on the ages at which pubertal stages were attained. Lactational exposures to DDE had no apparent effects; neither did transplacental or lactational exposure to PCBs. Girls with the highest transplacental PCB exposures were heavier for their heights than other girls by 5.4 kg, but differences were significant only if the analysis was restricted to white girls. CONCLUSIONS: Prenatal exposures at background levels may affect body size at puberty.     

Hypokalemia and Hyperkalemia in Infants and Children: Pathophysiology and Treatment

Potassium is the second most abundant cation in the body. About 98% of potassium is intracellular and that is particularly in the skeletal muscle. Electrical disturbances associated with disorders of potassium homeostasis are a function of both the extracellular and intracellular potassium concentrations. Clinical disorders of potassium homeostasis occur with some regularity, especially in hospitalized patients receiving many medications. This article will review the pathophysiology of potassium homeostasis, symptoms, causes, and treatment of hypo- and hyperkalemia.     

Prevention and treatment of overweight and obesity in children and adolescents

Increasing numbers of obese children and adolescents all over the world demand an investment in the primary and secondary prevention of obesity and overweight in this age group. The goal of preventive measures in children is to avoid the negative short- and long-term health problems associated with obesity. Primary prevention aims at establishing a healthy, active lifestyle and keeping children and adolescents within a range of body weight which is considered to be healthy. Constant availability and affordability of palatable and energy-dense food in the affluent society of the western world demands preventive strategies. Universal or public health prevention seems to be the most suitable form because several other cofactors of morbidity and mortality of affluent societies can also be prevented. However, in most European countries there is a lack of awareness of the necessity of prevention programmes, not only among the general population but also among the medical society. More awareness and consciousness to the problem of obesity must be generated in order to lead to effective therapeutic programmes. For those children and adolescents who are already obese, secondary prevention is mandatory. Therapeutic intervention programmes for the obese aim at long-term weight maintenance and normalisation of body weight and body fat. They have to modify eating and exercise behaviour of the obese child and establish new, healthier behaviour and lifestyle. Treatments programmes must include behavioural components in order to permanently change nutrition and physical exercise of the obese children and adolescents. However, long-term results of treatment programmes in European countries are scarce and the reported results, even of multidisciplinary regimens, are not impressive. Conclusion In most European countries there is an urgent need not only for a growing awareness of the problem of obesity in children and adolescents but also for development of new comprehensive approaches in treating this group.