~(125)碘——三碘甲状腺原氨酸血浆结合比值测定的分析

<正> 从甲状腺释放到血液循环中的甲状腺素(T_4)和三碘甲状腺原氨酸(T_3),大部分与血浆中的载体蛋白结合。它们是甲状腺素结合球蛋白(TBG)、白蛋白(Alb)和甲状腺素结合前白蛋白(TBPA)。 TBG对T_4、T_3有很高的亲和力,但与T_3的结合不如T_4牢固。Alb结合容量大,亲和力小,结合部分T_4和小部分T_3。TBPA对T_4的亲和力亦比TBG小,不结合T_3。一般认为TBG与T_4的结合,正常人约占其饱和状态的1/3。甲亢患者T_4、T_3增高,结合的多,剩余的TBG结合容量减小;甲减患者相反。血浆中T_4含量、TBG容量一定的情况下     

血清甲状腺素测定和临床应用

甲状腺素(下简称T_4)是甲状腺合成的氨基酸激素。甲状腺分泌T_4后,进入血液循环中,并与蛋白结合。T_4可与TBG(甲状腺结合球蛋白),TBPA(甲状腺结合前清蛋白)和白蛋白等结合。T_4与TBG结合最牢固,与TBPA的亲和力次之,与白蛋白结合最弱。甲状腺所产生的激素约90%都是T_4。因此,测定血清中T_4的含量可较精确地反映甲状腺功能。 1964年Murphy①介绍了利用T_4结合球蛋白(TBG)的特殊亲和力的特性测定了血清     

黄酮衍生物对大鼠体内甲状腺素结合前白蛋白的选择性竞争结合

合成的黄酮衍生物EMD_(21388)是T_4与甲状腺素结合前白蛋白(Thyroxine-bindingprealbumin,TBPA)结合的强烈抑制物。对大鼠全身使用EMD_(21388)后,血清TBPA与T_4结合即遭抑制,而白蛋白与T_4结合则增加,因而产生血清总T_4浓度降低,游离T_4百分率(FT_4％)增加以及血清TSH降低。提示在T_4与TBPA结合受抑,并与白蛋白结合增多的同时,由于血清T_4结合蛋白结合容量的减少,血清FT_4有短暂的增加;以及EMD_21388并不能通过血脑屏障。本文也进一步表明血清FT_4的稳定是垂体-甲状腺轴功能正常的十分重要的标志,以及大鼠血清游离甲状腺素的半衰期短于1h。     

溃疡病患者血清T_3、T_4改变

本文对30例溃疡病患者和32例轻度或中度慢性浅表性胃炎患者进行血清三碘甲状腺原氨酸(T_3)和血清总甲状腺素(T_4)浓度测定。溃疡病患者组血清T_3浓度与轻度或中度慢性浅表性胃炎组相比,有非常显著的降低(t=6.725,P<0.01);溃疡患者组血清T_4浓度与轻度或中度慢性浅表性胃炎相比,虽有下降,但差异不显著(t=1.785,P>0.05)。     

肾病综合征患者血清CA125水平与低蛋白血症的关系

目的观察肾病综合征患者血清CA125水平与血浆白蛋白水平及浆膜腔积液的关系。方法 31例原发性肾病综合征患者,根据血清白蛋白水平分为血白蛋白≥20 g/L组15例,血白蛋白<20 g/L组16例。另根据有无浆膜腔积液分为浆膜腔积液组16例,无浆膜腔积液组15例。血清CA 125水平采用化学发光标记免疫法(CLIA)测定。结果 31例患者中,血清CA125升高16例,占51.6%。浆膜腔积液16例,其中CA 125异常升高14例(87.5%)。血浆ALB<20 g/L患者16例,其中CA125异常升高14例(87.5%)。浆膜腔积液组的血清CA125水平明显高于无浆膜腔积液组(P<0.05)。肾病综合征患者伴浆膜腔积液者血白蛋白水平明显低于不伴浆膜腔积液患者(P<0.05)。血白蛋白<20 g/L组血清CA 125水平显著高于血白蛋白≥20 g/L组(P<0.05)。结论肾病综合征患者在严重低白蛋白血症(<20 g/L)伴浆膜腔积液时常伴有CA125明显增高。因此,血清CA125升高可能能反映肾病综合征时低蛋白血症的严重程度。     

26例尿毒症患者血透前后甲状腺激素的变化

我们于1988年5月至7月,观察了26例不同疾病所致尿毒症患者进行血透前后的血中促甲状腺素(TSH),总甲状腺素(TT_4),总三碘甲腺原氨酸(TT_3),3,3′,5′-三碘甲腺原氨酸(rT_3),~(125)I-T_3摄取比值(T_3MAA),并计算出游离 T_4指数(FT_4I),TT_3/rT_3比值以及 TBG 蛋白结合比值,并对其中5例患者作连续观察。结果表明尿毒症患者血中甲状腺激素与     

心得安对甲状腺毒症及甲状腺机能正常人循环中甲状腺激素测定的影响

β肾上腺素能阻滞剂如心得安能改善甲亢的症状和体征,除了β阻断作用外,它对循环中甲状腺激素的作用尚有争议。本文旨在研究心得安对循环中甲状腺激素水平的影响。研究对象为未治疗的甲状腺毒症患者10例,单纯用心得安,40mg 每6小时一次,共14天。治疗前后服末剂心得安后18小时分别采取血标本测定总T_4、T_3、游离 T_4和 T_3、rT_3、甲状腺素结合球蛋白(TBG)和甲状腺素结合前白蛋白(TBPA)。8例甲状腺机能正常的志愿者服用心得安,80mg,每     

糖尿病对甲状腺功能的影响——低T_3综合征

本文探讨糖尿病列甲状腺功能的影响,测定了30例未控制糖尿病患者血清T_3、T_4、FT_3、FT_4和TSH浓度。尽管临床上无甲状腺功能异常的表现,但血清低T_3者有15例(50%),低FT_3 10例(33.3%),低T_4 1例(3.3%)血清FT_4和TSH浓度除个别病例轻度增高外均正常。血清T_3/T_4比值显著降低,FT_3%和FT_4%显著增高。低T_3的产生与患者伴有的酮症酸中毒、高渗综合征、肺部感染等急性并发症显著相关。血清T_3浓度与空腹血糖和糖基血红蛋白水平呈负相关(P<0.01)。胰岛素治疗后,低T_3、低FT_3、低T_4等各项甲状腺功能试验均恢复正常。因此,血清FT_4测定是与甲减相鉴别的可靠依据,T_3、FT_3、T_4测定可作为判断糖尿病病情、预后和疗效的辅助指标。     

竞争性蛋白结合分析法测定血清甲状腺素(T_4)的浓度

竞争性蛋白结合分析和放射免疫分析,同属于放射性生化定量检测技术。竞争性蛋白结合分析法利用血清甲状腺素(T_4)和人血清甲状腺素结合球蛋白(TBG)结合得较牢固的特点,以标记T_4和被测样品中的T_4与TBG的相互竞争作用,进行血清微量激素的定量分析,因其具有灵敏、准确、特异性高等优点,近年来已在我国各地推广应用于临床。     

原发性支气管肺癌与转移性肺癌血清T_3、T_4及TSH测定的临床观察

本文报告了20例原发性支气管肺癌患者与17例转移性肺癌患者血清T_3、T_4及TSH含量的变化。我们观察到原发性肺癌组血清T_8、T_4明显低于正常人组和转移性肺癌组(P<0.001),而TSH含量差异无显著性(P>0.05);转移性肺癌组与正常人组比较血清T_3降低(P<0.05),但T_4及TSH差异无显著性(P>0.05)。     

Remission of hyperthyroidims and oral contraceptive therapy. [Answer to question

There is no endocrine contraindication to the use of oral contraceptives (OCs) in a 31-year-old nulliparous woman who presumably is in remission from hyperthyroidism. Yet, several important physiological and pathophysiological alterations must be appreciated to evaluate properly thyroid function in persons taking estrogen-containing preparations. Estrogens induce increased hepatic synthesis and release of thyroxine binding globulins (TBGs). Increased serum TBG concentrations result in a new thyroid hormone equilibrium characterized by an elevated serum thyroxine (T4) level and a reduced resin triiodothyronine (T3 uptake) level but a persistently normal serum-free T4 (FT4) level if the patient is euthyroid. When a patient with an increased serum TBG concentration becomes thyrotoxic, the T4 level rises further and the resin T3 uptake increases from low into the normal range. The calculated FT4 level increases into the thyrotoxic range. Thus, in patients with increased serum TBG levels, the calculated FT4 level is the critical serum determinant for laboratory assessment of thyroid function. If the FT4 level is equivocal in evaluating thyrotoxicosis in the presence of increased serum TBG values, then other clinical and laboratory parameters should be used. A thyroid suppression test or a thyrotropin-releasing hormone test might be useful when the serum parameters are not definitive. It is unnecessary to stop the use of OC preparations to evaluate thyroid function. At this time it is unclear whether the use of estrogen-containing medications influences the nature and extent of an autoimmune remission in Graves' disease. There is some evidence that autoimmune thyrotoxicosis is ameliorated or modified by factors in pregnancy.     

心脏围手术期血甲状腺激素的变化对术后病情和预后的影响

目的：观察心脏围手术期甲状腺激素的变化，研究其对心脏术后病情及预后的影响。方法：２１例心脏手术患者手术前后各时间占取静脉血标本，用放射免疫法测定甲状腺激素含量，并观察术后患者病情变化及预后。结果：体外循环（ＣＰＢ）期间以及术后Ｔ３、Ｔ４、ＦＴ３均明显降低，Ｔ３、Ｔ４在转流至最低体温时达到最低，术后５ｄ仍明显低于术前水平。ｒＴ３在ＣＰＢ期间稍下降，术后即迅速上升，２ｄ后达到高峰。分组研究表明，术后病     

15例肾病患儿甲状腺功能的测定

目的：探讨儿童肾病综合征（ＮＳ）和慢性肾衰竭（ＣＲＦ）导致甲状腺功能异常改变的机理,及在血浆蛋白异常改变时采用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）测定法评价甲状腺功能。方法：采用酶学免疫测定法检测了１５例肾脏疾病患儿的血清ＦＴ３、ＦＴ４和ＴＳＨ。其中８例为ＮＳ,７例为ＣＲＦ。并与７例ＮＳ恢复期（ＲＥＮＳ）患儿及９例正常儿童（ＮＣ）为对照。结果：与ＲＥＮＳ和ＮＣ对照组相比,ＮＳ组的ＦＴ４降低、ＴＳＨ升高（均Ｐ＜００５）。ＣＲＦ组ＦＴ４和ＦＴ３均明显降低（Ｐ＜００５）,而ＴＳＨ无明显改变（Ｐ＞００５）。ＲＥＮＳ的各项指标与ＮＣ无差异（Ｐ＞００５）。ＮＳ和ＣＲＦ的血清ＦＴ３、ＦＴ４和ＴＳＨ的改变与血清蛋白、尿蛋白均无相关关系。结论：ＮＳ和ＣＲＦ急性期患儿都存在着甲状腺功能指标异常降低,ＮＳ恢复期甲状腺功能可恢复正常,提示无需甲状腺激素治疗;而ＣＲＦ可导致中枢性的甲状腺功能障碍,甲状腺激素治疗有一定价值。     

肾病综合征与失代偿期肝硬化患者血清甲状腺激素水平的检测及其临床意义

目的： 观察肾病综合征、失代偿期肝硬化患者血清甲状腺激素水平的变化,阐明血清甲状腺激素水平与血清白蛋白水平之间的关系。方法： 采用电化学发光免疫法测定30例肾病综合征、30例失代偿期肝硬化患者和30例正常对照组研究对象空腹血清中的促甲状腺激素（TSH）、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平,分析其血清甲状腺激素水平与血清白蛋白水平之间的相关性。结果：2组患者血清中FT4、FT3水平较正常对照组下降(P<0.01）,而TSH水平较正常对照组升高（P<0.01）。肾病综合征组患者血清FT3、FT4水平与血清白蛋白水平呈正相关关系（r₁=0.493,r₂=0.574,P<0.01）;失代偿期肝硬化组患者血清FT3、FT4水平与血清白蛋白水平亦呈正相关关系（r₁= 0.513,r₂=0.607,P<0.01）。2组患者TSH水平与血清白蛋白水平之间无相关性（r₁=－0.232,r₂=
－0.129,P>0.05）。结论： 肾病综合征、失代偿期肝硬化患者常出现血清FT3、FT4水平的降低,随着血清白蛋白水平的好转,血清FT3、FT4的水平升高。     

Type 1 iodothyronine deiodinase activity and mRNA expression in rat thyroid tissue with different iodine intakes

Background Type 1 deiodinase （D1） plays an important role in the metabolism of thyroid hormone and has close relationship with thyroid function. In this study we explore the effects of iodine intake on D1 activity and its mRNA expression and its possible mechanism. Methods Forty-eight Wistar rats were randomly divided into six groups with 8 in each： low iodine （LI）, normal iodine （NI）, five-fold iodine （HI5）, ten-fold iodine （HI10）, fifty-fold iodine （HI50）, one hundred-fold iodine （HI100） group. Three months, six months and twelve months after admistration of potassium iodate, they were sacrificed and thyroids were excised. The expression of D1 mRNA in the thyroid tissue was determined by RT-PCR and D1 activity was analyzed by ^125I-rT3 as substrate. The thyroid hormone was measured with radioimmunoassay method. Results Compared with NI group, D1 mRNA expression in LI groups slightly decreased, and D1 activity greatly increased. Both T3 and T4 in thyroid tissue significantly decreased, but the T3/T4 ratio increased. D1 mRNA expression decreased in all HI groups, and D1 activity was significantly lower in HI groups. There was a tendency of decrease in D 1 activity with increased doses of iodine intakes. There was no significant difference in T4 in thyroid tissue between HI groups and NI group, but a tendency of decrease in T3 level was found in all HI groups. Conclusions In the case of iodine deficiency, D 1 activity increased greatly in order to convert more T4 to T3. Excess iodine can inhibit both D1 mRNA expression and its activity to protect organism from being injured by excessive T3.     

Changes of Thyroid Hormone Levels in Epileptic Patients

ＣｈａｎｇｅｓｏｆＴｈｙｒｏｉｄＨｏｒｍｏｎｅＬｅｖｅｌｓｉｎＥｐｉｌｅｐｔｉｃＰａｔｉｅｎｔｓＺＨＵＳｕｉ－ｑｉａｎｇ（朱遂强）；ＬＩＵＸｉ－ｍｉｎｇ（刘锡民），ＲＵＡＮＸｕ－ｚｈｏｎｇ（阮旭中）；ＣＡＩＺｈｕａｎ（蔡转）（Ｄｅｐａｒｔｍｅｎｔｏｆ...     

Type 1 iodothyronine deiodinase activity and mRNA expression in rat thyroid tissue with different

Background  Type 1 deiodinase (D1) plays an important role in the metabolism of thyroid hormone and has close relationship with thyroid function. In this study we explore the effects of iodine intake on D1 activity and its mRNA expression and its possible mechanism.
Methods  Forty-eight Wistar rats were randomly divided into six groups with 8 in each: low iodine (LI), normal iodine (NI), five-fold iodine (HI₅), ten-fold iodine (HI₁₀), fifty-fold iodine (HI₅₀), one hundred-fold iodine (HI₁₀₀) group. Three months, six months and twelve months after admistration of potassium iodate, they were sacrificed and thyroids were excised. The expression of D1 mRNA in the thyroid tissue was determined by RT-PCR and D1 activity was analyzed by ¹²⁵I-rT3 as substrate. The thyroid hormone was measured with radioimmunoassay method.
Results  Compared with NI group, D1 mRNA expression in LI groups slightly decreased, and D1 activity greatly increased. Both T₃ and T₄ in thyroid tissue significantly decreased, but the T₃/T₄ ratio increased. D1 mRNA expression decreased in all HI groups, and D1 activity was significantly lower in HI groups. There was a tendency of decrease in D1 activity with increased doses of iodine intakes. There was no significant difference in T₄ in thyroid tissue between HI groups and NI group, but a tendency of decrease in T₃ level was found in all HI groups.
Conclusions  In the case of iodine deficiency, D1 activity increased greatly in order to convert more T₄ to T₃. Excess iodine can inhibit both D1 mRNA expression and its activity to protect organism from being injured by excessive T₃.

     

Abnormalities of thyroid function tests in hospital inpatients

Results of thyroid function tests were analysed in 199 clinically euthyroid inpatients with normal serum thyroid stimulating hormone values. Serum total triiodothyronine was less than 1.25 nmol/l in 61.8% of samples, free triiodothyronine less than 3.9 pmol/l in 57.8%, total thyroxine less than 63 nmol/l in 21.1% and free thyroxine less than 9.5 pmol/l in 17.6%. In contrast, thyroxine binding globulin ratio was below normal (less than 5) in only 5 samples. A significant positive correlation (P less than 0.001) of serum free thyroxine with total thyroxine, thyroxine/thyroxine binding globulin ratio and free triiodothyronine was present as well as a significant negative correlation (P less than 0.001) with serum thyroid stimulating hormone. There was no correlation of free thyroxine measurements with serum albumin or non-esterified fatty acid concentrations. Although serum free thyroxine is low in a number of patients with non-thyroidal illnesses, this does not appear to be due to a rise in non-esterified fatty acids or a fall in albumin as has been proposed. Serum thyroid stimulating hormone measurements are essential to confirm the diagnosis of hypothyroidism in such subjects.     

肝病患者血清甲状腺激素变化

测定１０９例不同肝病患者的血清甲状腺激素，与对照组比较，肝炎组Ｔ４、ｒＴ３、ｒＴ３／Ｔ３升高（Ｐ〈０．０５），Ｔ３／Ｔ４降低（Ｐ〈０．０１）。肝硬化组Ｔ３、Ｔ３／Ｔ４降低（Ｐ〈０．０１），ｒＴ３、ｒＴ３／Ｔ３升高（Ｐ〈０．０５），部分重症患者伴有Ｔ４降低。血清Ｔ３、Ｔ４与肝病患者血清胆红素、血浆白蛋白密切相关。血清Ｔ３含量尤其是Ｔ４浓度可预测肝病患者的预后，讨论了甲状腺激素浓度异常的发生机理和临床