四君子汤对家兔下丘脑神经递质-甲状腺轴的调节作用及机理研究

目的:研究家兔衰老增龄过程中下丘脑-甲状腺轴功能的变化及四君子汤的调节作用。方法:采用放 射免疫分析测定甲状腺素(T3、T4),促甲状腺释放激素(TRH),促甲状腺素(TSH),β-内啡肽(β-EP),P物质 (SP),去甲肾上腺素(NE),多巴按(DA),5羟色胺(5-HT)的水平。结果:四君子汤组家兔下丘脑中NE、DA、5- HT、β-EP、SP、TRH、TSH和血清中T3、T4含量明显高于老龄对照组,有显著性差异(P<0.01)。而上述指标老龄 对照组与成年对照组相比,明显低于成年对照组(P<0.01)。结论:老龄家兔组下丘脑机能减退是甲状腺机能减 退的重要原因,四君子汤可能改善老龄家兔的下丘脑调控机能,延缓甲状腺轴机能的老年性变化。     

儿童生长激素缺乏症临床试验的综合评估(附20例临床分析)

目的评价20例生长激素缺乏症(GHD)儿童激素水平,包括生长激素(GH)、游离甲状腺素(FT3、FT4)、促甲状腺素(TSH)、促性腺激素(LH及FSH)、空腹血糖与垂体CT.方法所有内分泌激素均经放射免疫法(RIA)测定.生长激素激发试验分别给以口服左旋多巴(10mg/kg)及静脉注射胰岛素(0.05～0.1U/kg).随后,在0、30、60、90分钟分别抽血测定.空腹血糖为常规方法测定.垂体CT为冠状位增强扫描.结果20例中GH完全缺乏16例,GH部分缺乏症4例.其中2例合并中枢性甲状腺功能低下,2例合并外周性甲状腺功能低下.20例中15例促性腺激素分泌不足.垂体CT显示垂体正常7例,垂体发育不良10例,空蝶鞍3例.空腹血糖低于正常水平12例.结论生长激素缺乏症除生长激素分泌不足外,易伴发性腺及甲状腺功能受损.空腹血糖水平较易低下.提示对这类患儿应综合评估.垂体CT提示患儿垂体可有不同程度异常,不应忽视.     

胃复安与下丘脑-垂体-甲状腺轴的关系及临床意义

下丘脑分泌的促甲状腺激素释放激素(Thyrotropin—releasing hormone，TRH)促进垂体促甲状腺激素(Thyrotropin，TSH)的合成和释放，而多巴胺(Dopamine，DA)和生长抑素(Somatostatin，SST)抑制TSH的合成和释放，甲状腺激素也对TSH产生反馈抑制作用。甲状腺功能减退患者，伴随多巴胺能神经元功能(Dopaminergietone)的降低和TSH基础水平升高。胃复安(Metoclopramide，MCP)是多巴胺第二受体拮抗剂，能加速提高甲低患者血TSH水平，特别是当运用于分化型甲癌(Differentiated thyroid carcinoma，DTC)病人时，能缩短停用左旋甲状腺素(L—thyroxine，L—T4)的时间和减轻甲状腺机能减退所致的症状和体征，有助于对DTC病灶的^131I显像诊断和^131I治疗。     

131I治疗前后甲状腺素变化对分化型甲状腺癌患者脂蛋白α的影响研究

目的 研究131I治疗前后分化型甲状腺癌患者脂蛋白α(Lp-α)代谢的影响,及甲状腺素、血脂指标与脂蛋白α间的关系.方法 选取2015年至2018年在我院接受131I治疗分化型甲状腺癌患者128例(男性45例,女性83例),测定患者停药前及甲状腺素撤出及替代抑制治疗后Lp-α及各项血脂指标、血清游离甲状腺素(FT4)、游离三碘甲酰原氨酸(FT3)、促甲状腺素(TSH),分析甲状腺素变化对患者血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白α(Lp-α)影响,分析甲状腺素、血脂指标与Lp-α间关系.结果 随着甲状腺素撤出后,患者 Lp-α、TG、TCHO、HDL-C、LDL-C、TSH 均明显增高,FT3、FT4下降,P 均＜0.01.Lp-α 与 LDL-C 呈正相关;TC与TG、HDL-C、LDL-C、TSH呈正相关;与FT3、FT4呈负相关.HDL-C与TSH、LDL-C呈正相关;与FT3、FT4呈负相关;LDL-C与FT3、FT4呈负相关,与TSH、Lp-α呈正相关;甲状腺素替代治疗4周后,患者甲状腺相关指标及血脂指标恢复至停药前水平,两者比较差异无统计学意义.结论 131I治疗前后甲状腺素的变化可引起Lp-α水平变化;该变化与甲状腺指标无明显关系,与LDL-C呈正相关,经替代抑制治疗后,各项指标均可恢复至停药前水平.     

亮氨酸脑啡肽与TRH-TSH-甲状腺轴互相影响的研究

目的：探索阿片类物质与TRH－TSH－甲状腺轴之间的关系的相互影响。方法：制造大鼠高甲状腺激素水平及低甲状腺激素水平动物模型,用放免法测定甲状腺激素（T3、T4、TRH、TSH）、鸦片类物质亮氨酸脑啡肽（L－EK）及用高压液相－电化学法测定神经递质5－羟色胺（5－HT）。结果：高甲组T3、T4呈逐渐升高（P＜0．01）;血清TRH迅速下降以后又回升;下丘脑TRH呈持续抑制状态,TSH显著降低（P＜0．001）,L－EK升高（P＜0．05）,5－HT降低（P＜0．05）。低甲组T3、T4显著降低（P＜0．001）,血清TSH、TRH含量逐渐升高（P＜0．001）,垂体TSH、下丘脑TRH含量逐渐降低（P＜0．01）,以后又回升;L－EK升高,5－HT降低（P＜0．01）。结论：甲状腺功能改变后TRH、TSH升高而降低,并不伴随脑纹状体中L－EK必然的同步升高而降低。     

充血性心力衰竭患者血清甲状腺激素和细胞因子的变化及临床意义

目的:通过对充血性心力衰竭(CHF)患者血清甲状腺激素及细胞因子的变化,来探讨其临床应用的价值.方法:采用放射免疫分析监测90例CHF患者及30例健康者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),肿瘤坏死因子(TNF-α)的浓度变化,比较各组间的差异,并对FT3和TNF-α进行相关分析.结果:甲状腺激素的水平随心功能不同而变化,心功能Ⅳ级时FT3明显降低、TNF-α明显升高,与心功能Ⅱ级、Ⅲ级相比较有显著性差异(P＜0.01或P＜0.05);FT4略有下降,但与心功能Ⅱ级、Ⅲ级相比较无显著性差异(P＞0.05).相关性分析表明,FT3与TNF-α呈负相关(r=-0.577).结论:CHF时甲状腺激素的代谢发生了明显的变化,而且心功能程度与甲状腺激素水平、细胞因子水平有明显的相关关系.     

2型糖尿病患者血清TGA、TPO-Ab及甲状腺激素检测的评价

目的:探讨检测2型糖尿病(DM2)患者血清TGA、TPO-Ab及甲状腺激素含量的临床意义.方法:采用化学发光免疫分析(CLIA)测定82例DM2患者血清中甲状腺球蛋白抗体(TGA)、甲状腺过氧化物酶抗体(TPO-Ab)及游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺素(TSH)水平.结果:与68例正常...     

甲状腺功能亢进患者血清FT3、FT4及TSH变化与血尿酸的关系研究

目的:分析甲状腺功能亢进患者血清游离三腆甲状腺原氨酸(Free trithyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)、促甲状腺素(Thyrotropin,TSH)变化与血尿酸(Uric acid,UA)的关系.方法:收集本院2019年10月至2021年11月收治的105例甲状腺功能亢进患者的临床资料.另选取同期健康体检者75例作为对照组.比较两组治疗前后FT3、FT4、TSH及UA水平;并分析FT3、FT4及TSH与UA的关系.结果:甲亢组FT3、FT4及UA水平明显高于对照组,TSH水平低于对照组(P<0.05).甲亢组治疗后FT3、FT4及UA水平较治疗前明显降低,TSH水平较治疗前明显增高(P<0.05).甲状腺功能亢进患者FT3、FT4水平与UA水平呈正相关关系(r=0.673、0.626,P<0.05);TSH水平与UA水平呈负相关关系(r=-0.736,P<0.05).结论:甲状腺激素对UA水平具有一定调节作用,甲状腺功能亢进患者FT3、FT4及TSH变化与UA存在明显相关性.     

压力型抑郁症的患者血清rT3和Cortisol的变化研究

目的 研究探讨反-三碘甲状腺原氨酸(rT3)和皮质醇(Cortisol)在由于压力引发抑郁症患者中的临床应用.方法 本研究纳入39例由于压力引发的抑郁症患者(研究组),以及40例正常体检者(对照组),使用化学发光免疫分析法检测甲状腺功能以及肾上腺功能激素,包括促甲状腺素(TSH)、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、反-三碘甲状腺原氨酸(rT3)以及皮质醇(Cortisol)含量,并进行比较分析;同时根据病程对研究组进行分组比较.结果 研究组血清rT3以及Cortisol水平显著高于正常对照组(P＜0.01),而根据病程的不同,其T3、rT3水平也存在显著差异(P＜0.05).结论 压力型抑郁症会导致患者甲状腺以及肾上腺功能异常.     

原子力显微镜在细胞生物学研究中的应用

下丘脑分泌的促甲状腺激素释放激素 (Thyrotropin- releasing hormone,TRH)促进垂体促甲状腺激素(Thyrotropin,TSH)的合成和释放 ,而多巴胺 (Dopam ine,DA)和生长抑素 (Som atostatin,SST)抑制 TSH的合成和释放 ,甲状腺激素也对 TSH产生反馈抑制作用。甲状腺功能减退患者 ,伴随多巴胺能神经元功能 (Dopam inergictone)的降低和 TSH基础水平升高。胃复安 (Metoclopramide,MCP)是多巴胺第二受体拮抗剂 ,能加速提高甲低患者血 TSH水平 ,特别是当运用于分化型甲癌 (Differentiated thyroid carcinom a,DTC)病人时 ,能缩短停用左旋甲状腺素 (L- thyroxine,L- T4 )的时间和减轻甲状腺机能减退所致的症状和体征 ,有助于对 DTC病灶的 1 31 I显像诊断和 1 31 I治疗     

急性脑血管病患者甲状腺激素检测的临床意义

目的:探讨急性脑血管病患者甲状腺激素的变化及其临床意义.方法:将126例急性脑血管病患者分为脑出血组和脑梗死组,采用放射免疫分析动态观察其甲状腺激素水平,同时检测80例同龄健康体检者血清甲状腺水平.结果:①与对照组比较,脑出血组和脑梗死组血清T3和FT3降低(P＜0.01)血清rT3、T4 、FT4增高(P＜0.01),血清TSH无差别(P＞0.05);与脑梗死组比较,脑出血组血清T3和FT3降低(P＜0.05).②与轻型组和中型组比较,重型组血清T3和FT3降低(P＜0.01),血清rT3、T4 、FT4增高(P＜0.01),TSH在各组间无显著差异(P＞0.05).结论: 急性脑血管病患者急性期的保护性应激反应可引起T3和FT3下降,rT3升高,其中T3和FT3的降低与病情严重程度及预后密切相关.     

Effects of growth hormone treatment on thyroid function in pediatric patients with Prader–Willi syndrome

It is unclear whether hypothyroidism is present in patients with Prader–Willi syndrome (PWS). This study aimed to clarify the state of the hypothalamic–pituitary–thyroid axis and the effects of growth hormone (GH) treatment on thyroid function in pediatric patients with PWS. We retrospectively evaluated thyroid function in 51 patients with PWS before GH treatment using a thyroid‐releasing hormone (TRH) stimulation test (29 males and 22 females; median age, 22 months). We also evaluated the effect of GH therapy on thyroid function by comparing serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) levels at baseline, 1 year, and 2 years after GH therapy. TSH, fT4, and fT3 levels were 2.28 μU/ml (interquartile range [IQR]; 1.19–3.61), 1.18 ng/dl (IQR; 1.02–1.24), and 4.02 pg/dl (IQR; 3.54–4.40) at baseline, respectively. In 49 of 51 patients, the TSH response to TRH administration showed a physiologically normal pattern; in two patients (4.0%), the pattern suggested hypothalamic hypothyroidism (delayed and prolonged TSH peak after TRH administration). TSH, fT4, and fT3 levels did not change significantly during 1 or 2 years after GH treatment. The TSH response to TRH showed a normal pattern in most patients, and thyroid function did not change significantly during the 2 years after initiating GH treatment.     

Thyrotropin-releasing hormone enhances event-related brain potentials and growth hormone release in man

Changes in contingent negative variation (CNV), a brain-evoked potential related in arousal, as well as in serum triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), prolactin (PRL), cortisol and growth hormone (GH) levels were recorded in 12 male volunteers receiving either thyrotropin-releasing hormone (TRH) or saline infusion. Only during TRH administration an increase in CNV (P less than 0.02) and, 30 min later, in GH (P less than 0.05) occurred; thyroid hormones and PRL increased as well, in the absence of any correlation with CNV areas. Cortisol was not affected by TRH. As dopamine (DA) agonistic drugs notoriously increase both CNV areas and GH levels and experimental evidence for prodopaminergic properties of TRH has accumulated in animal models, a possible explanation of the results here presented might be the activation of DA pathways by TRH also in the human.     

Pituitary-thyroid function and thyrotropin, prolactin and growth hormone responses to TRH in patients with chronic alcoholism

Basal plasma concentrations of thyroxine (T4), 3,3',5-triiodothyronine (T3), free T4 index (TF4I), free T3 index (FT3I) reverse T3, 3,3',5-triiodothyronine (rT3), resin T3 uptake (TR3U), thyroxine-binding globulin (TBG), thyrotropin (TSH), prolactin (PRL) and growth hormone (GH) as well as thyrotropin releasing hormone (TRH) stimulated TSH, PRL and GH were investigated in 31 consecutive male patients (mean age 41 years) with chronic alcoholism. According to the histology of their liver biopsies the patients were divided into three groups: patients with normal livers, steatosis and cirrhosis. The control group consisted of 30 healthy males. The patients had abstained from alcohol for at least one week when studied, and they were on a nutritionally adequate diet. All had consumed a daily minimum of 52 g ethanol for at least 5 years. None of the patients had severe or decompensated liver disease. The patients had significantly reduced T3 and rT3 plasma levels compared to normals. Patients with cirrhosis of the liver had increased TBG and normal RT3U levels, while those without cirrhosis had increased RT3U and normal TBG levels. Plasma concentrations of basal as well as TRH-stimulated TSH and PRL were unchanged in alcoholic patients, whereas basal as well as stimulated GH levels were increased in cirrhotic alcoholics. It is concluded that alcohol per se influences T3 levels, but not the part of the hypothalamic-pituitary axis studied, and that the binding proteins are mostly determined by the degree of liver disease.     

肿瘤坏死因子,白细胞介素—1对鼠甲状腺激素的影响

目的：探讨肿瘤坏死因子和白细胞介素－１对机体甲状腺激素的影响。方法：将重组人的肿瘤坏死因子和白细胞介素－１分别或联合注入大白鼠体内,检测其体内甲状腺激素水平变化,采用放射免疫分析法检测血清Ｔ３、Ｔ４、游离Ｔ３（ＦＴ３）,游离Ｔ４（ＦＴ４）及ＴＳＨ。结果：给予鼠一次性注射瘤坏死因子（ＴＮＦ）５０μｇ／只,其血清Ｔ３,ＦＴ３,ＦＴ４明显低于对照组,而血清Ｔ４、ＴＳＨ无明显改变。给予白细胞介素－１（ＩＬ     

Paradoxical responses of plasma cortisol, adrenocorticotropic hormone and growth hormone to thyrotropin-releasing hormone and luteinizing-hormone-releasing hormone in anorexia nervosa patients

Abnormalities of hypothalamic-pituitary function in patients with anorexia nervosa (AN) have been reported previously. Since atypical responses to thyrotropin-releasing hormone (TRH) and luteinizing-hormone-releasing hormone (LHRH) have been observed in other disease states, hormonal responses to these hypothalamic peptides in 60 otherwise unstressed young women with anorexia nervosa were studied. Sixteen patients demonstrated a growth hormone (GH) response to TRH and 10 showed an increase in GH after LHRH. Five patients had an increase in cortisol after TRH, 2 of whom showed GH response, and 2 patients demonstrated a cortisol response to LHRH, 1 of whom had a GH response. Variable TSH responses to TRH were observed in the study but there was no correlation with the occurrence of GH or cortisol responses. GH responses to TRH and LHRH were typically not seen in the same patients, nor were they predictive of a cortisol response to the same stimulus. These data add to the evidence for an abnormal hypothalamic-pituitary regulation in AN.     

消化道肿瘤患者血清甲状腺激素水平的变化及临床意义

目的:探讨消化道肿瘤患者血清甲状腺激素谱的变化.方法:应用放射免疫分析(RIA)检测33例消化道肿瘤患者的血清T3、FT3、T4、FT4和TSH,并与健康人群(对照组)40例作对照.结果:恶性消化道肿瘤患者血清T3、FT3值均明显降低,与正常对照组相比有显著性差异(P＜0.01);T4和FT4值轻度降低,但与对照组无显著性差异(P＞0.05),TSH值无明显变化(P＞0.05).晚期恶性肿瘤患者与早期相比,T3、FT3、T4、FT4值均明显降低(P＜0.01),TSH轻度降低,但差异不显著(P＞0.05).结论:监测消化道肿瘤患者血清甲状腺激素谱改变对判断疾病的严重程度及预后估计有积极意义.     

急性胰腺炎患者垂体-甲状腺轴的变化及意义

目的 :探讨急性胰腺炎患者垂体 -甲状腺轴的功能变化及意义。方法 :用放射免疫分析 73例急性胰腺炎患者和 33例正常人血清T3 、FT3 、T4、FT4、rT3 、TSH水平 ,其中轻型急性胰腺炎 (mAP) 5 7例 ,重症急性胰腺炎 (sAP) 16例 ,并检测了其中 39例患者 (mAP2 8例 ,sAP11例 )恢复期血清上述激素水平。结果 :急性胰腺炎(mAP组和sAP组 )急性期T3 、FT3 、TSH显著低于正常 (p均 <0 0 5 ) ,rT3 升高 (p <0 0 1) ,恢复期T3 、FT3 虽有回升(与急性期比较p <0 0 1,0 0 5 ) ,但仍未恢复到正常水平 (与正常对照组比较p<0 0 1) ,rT3 恢复正常。mAP组急性期T4、FT4无异常改变 ,恢复期TSH接近正常 (p >0 0 5 ) ,sAP组急性期T4、FT4降低 ,与正常对照比较 (p <0 0 1) ,恢复期T4、FT4有所升高 (与急性期比较p<0 0 1) ,但均未达到正常水平 (p均 <0 0 1) ,同时发现mAP组T3 、FT3 、T4、FT4均高于sAP组 ,而rT3 、TSH两组无差异 (p >0 0 5 )。结论 :血清T3 、FT3 、T4、FT4水平可作为急性胰腺炎病情严重程度评估的一个指标。     

急、慢性支气管炎患者血清TH的水平分析

目的：为了研究TH（甲状腺激素）与急、慢性支气管炎患者病情严重程度的关系。方法：本文利用RIA和CLIA测定了107例急性支气管炎,87例慢性支气管炎治疗前后和47例正常对照组血清中的FT3,T3,FT4,T4,TSH和T3/rT3的水平。结果：47例正常对照组血清FT3,T3,FT4,T4,TSH和T3/rT3的水平分别为（4.81±1.31）pmol/L,（1.34±0.41）ng/ml,（14.61±3.33）pmol/L,（84.11±18.70）ng/ml,（2.46±1.39）mIu/L和2.61±0.67,男女之间无明显差异（P〉0.05）。107例急性支气管炎、87例慢性支气管炎治疗前后血清FT3,FT4,T4和TSH水平与正常对照组无明显差异（P〉0.05）;而血清T3明显降低（P〈0.05或〈0.01）,rT3明显增高（P〈0.05或〈0.01）;慢性支气管炎治疗后较治疗前血清T3明显增加（P〈0.05）,血清rT3明显降低（P〈0.05）。结论：本文表明,急慢性支气管炎患者血清中T3和T3/rT3水平是重要的标志物,并能反映疾病的严重程度。     

甲亢患者治疗前后血清FT3、FT4和S IL-2R水平的变化及临床意义

目的：探讨了甲亢患者治疗前后血清FT3、FT4和SIL-2R水平的变化及临床意义。方法：分别应用放免法和酶联免疫法对55例甲亢患者进行了治疗前后血清FT3、FT4和SIL-2R水平的变化观察,并与35名正常健康人作比较。结果：治疗前血清FT3、FT4和SIL-2R水平非常显著地高于正常人组（P〈0.01）,经治疗后3个月则与正常人比较无显著性差异（P〉0.05）,血清SIL-2R水平与FT3、FT4呈明显正相关（r=0.6018、0.6117,P〈0.01）。结论：检测甲亢患者血清FT3、FT4和SIL-2R水平的变化,对观察疗效和预后判断有一定的临床使用价值。