甲状腺功能减退症与高尿酸血症

甲状腺功能减退症与高尿酸血症或痛风伴发比例高,甲状腺激素可直接作用于肾脏导致尿酸排泄减少,也可通过调节瘦素水平影响肾脏对尿酸排泄,同时高尿酸血症或痛风通过作用于下丘脑-垂体-甲状腺轴,影响甲状腺激素的合成及分泌,高尿酸血症也可刺激瘦素基因表达或减少其清除,从而影响甲状腺激素水平.甲状腺激素水平降低和血尿酸水平升高是代谢综合征的危险因素,胰岛素抵抗是代谢综合征的核心,故胰岛素抵抗可能是联系高尿酸血症与甲状腺功能减退症的关键环节.     

甲状腺机能减退与脑发育

甲状腺功能减退症是以低甲状腺激素血症为特点的内分泌疾病.甲状腺激素的减少可影响机体各器官、系统的功能,其中对大脑发育的影响临床上较为常见.甲状腺功能减退可造成一系列脑发育和功能的障碍,包括细胞增殖分化的延迟和学习记忆功能的下降.     

甲状腺功能减退症与心血管病

目的全面了解甲状腺功能减退症(甲减)患者心血管系统表现和心血管并发症、合并症,为诊断甲减提供参考。方法回顾性分析心血管内科收入的甲减患者心血管系统表现和心血管并发症、合并症及其构成比、内在的相互关系。结果本研究甲减患者男性少于女性(男女人数1∶3),半数以上有相关病史;可合并(并发)贫血、心房纤颤、高血压病、冠心病、心包积液、高脂血症等心血管病;可存在多种非特异性的心电图异常,可有血清肌酶升高;贫血、血脂升高、心包积液、肌酶升高可同时存在或两种以上情况并存,如一个患者同时无这四种(或后三种)情况可排除甲减。结论甲减与心血管病有密切、广泛的联系,血脂升高、心包积液、肌酶升高、贫血至少存在一项异常。     

Hypothyroidism and pleural effusions

Serous effusions have been thought to be an unusual complication of hypothyroidism and most commonly have been associated with ascites, pericardial fluid and heart failure. Pleural fluid as an isolated finding in hypothyroidism is apparently rare and complete analysis of these hypothyroid-associated pleural effusions has not been described. To determine the frequency, chemical characteristics and clinical associations of hypothyroidism and pleural effusions, the medical records of 128 patients with hypothyroidism (defined by an increased serum TSH concentration) were reviewed. The majority of effusions in patients with hypothyroidism were due to other diseases. Effusions solely due to hypothyroidism appeared to be a real entity. These effusions were borderline between exudates and transudates and showed little evidence of inflammation.     

Hypothyroidism and heart failure

Effects of thyroid gland hormones on cardiovascular system have been known for many years. Thyroid gland hormones deficiency is connected with a range of metabolic and hemodynamic changes which can contribute to a genesis of heart failure. Recent works refer to an importance of connection of thyroid gland hormones metabolism with heart insufficiency pathophysiology. That is especially a syndrome of a low trijodthyronin level marked as euthyroid sick syndrome which is significantly more frequent in patients with chronic heart failure compared to a population of healthy individuals. Recent clinical works proved that treatment administration of thyroid gland hormones to patients with heart failure is connected with favourable hemodynamic changes and increased working capacity if the treatment is well tolerated.     

脑出血后继发性水肿和神经损害的机制

脑出血后血肿周围继发性水肿和神经损伤是脑出血患者预后不良的重要因素。近年来 ,对针对脑出血后继发性神经损害机制的干预措施进行了一些研究 ,并取得了一些进展。     

��״�ٹ��ܼ�����Ѫ֬�쳣

??Abstract??Hypothyroidism often results in the elevation of serum total cholesterol??low-density lipoprotein cholesterol and triglyceride??and is one of common causes for secondary dyslipidemia.This association is mainly attributed to the reduction of circulating thyroid hormones.Recently??results from epidemiological studies showed that subclinical hypothyroidism??defined as a serum thyroid stimulating hormone (TSH) concentration above the normal range with normal serum FT??4 and FT??3 concentration??was closely associated with dyslipidemia.Experimental studies confirmed the role of TSH per se in lipid metabolism.For overt hypothyroidism??replacement therapy with thyroid hormones can correct dyslipidemia.However??the beneficial effects of replacement therapy on dyslipidemia in subclinical hypothyroidism were not established by clinical trials??which warrants further intervention studies to answer it.     

Hypothyroidism and ventilator dependency

Four patients with long-term ventilator dependency and severe hypothyroidism discovered in a single year are described. Correction of hypothyroidism was helpful in weaning three patients from the ventilator. The fourth patient died of other medical problems. None of these patients had goiter or clinical evidence of hypothyroidism. Hypothyroidism was discovered during workup for neurologic or cardiologic problems. Although hypothyroidism is not a common cause of ventilator dependency, it might be more common than we think.     

Pulmonary Edema Due to <Emphasis Type="Italic">Plasmodium vivax</Emphasis> Malaria in an American Missionary

Abstract Pulmonary edema is a recognized complication of Plasmodium falciparum malaria but is uncommon with Plasmodium vivax infection. We report the case of a non-immune adult with imported P. vivax malaria who developed pulmonary edema during treatment. The case was further complicated by a recurrent malaria episode after failure of acute quinine and doxycycline treatment followed by terminal primaquine therapy. Prompt recognition and appropriate management of pulmonary edema is needed for optimal outcomes of P. vivax infection, as well as awareness of the potential failure of terminal therapy for liver hypnozoites.