胎儿甲状腺功能检测的方法及临床应用研究

采用改进的体外放射分析方法对２０名正常和２８例治疗中的患甲状腺疾病孕妇的１９￣２２周羊水中Ｔ３、Ｔ４、ＴＳＨ、ｒＴ３及ＴＲＡｂ进行了测定。并对患者孕妇妊娠期间的甲状腺功能进行了跟踪监测。最终以新生儿静脉血的检查来判断有无先天性甲低。结果表明,正常和患者两组间羊水中甲状腺有关激素及抗体的浓度无显著差异;２８例患者妊娠期间血清甲状腺激素水平基本在正常范围;新生儿检查结果全部正常。提示在妊娠期保持孕妇甲     

孕中晚期母儿甲状腺功能与胎儿生长发育的关系

本文研究目的是了解妊娠期间母儿甲状腺功能关系及对胎儿生长发育的影响,利用放射免疫法和免疫放射法测定了１６９例妊娠中、晚期正常孕妇及胎儿的血清Ｔ３,Ｔ４,ＴＳＨｎ３值,并记录胎儿体重。根据测定数据得出如下结论：１．正常妊娠中晚期母儿间的甲状腺系统没有显著联系,并且,孕中晚期母体甲状腺功能胎儿体重生长没有显著影响。２．胎儿甲状腺激素中Ｔ４,ＦＴ３,ＦＴ４与胎儿体重生长呈正相关,ＴＴ３与胎儿体重生长吾负     

中西医结合治疗急性动脉栓塞过程中甲状腺激素测定的临床意义

目的：探讨甲状腺激素水平在急性动脉栓塞中中西医结合治疗过程中的变化规律及其临床意义。方法：利用放射免疫分析法对４０例本病患者及３０例健康对照组进行血清甲状腺激素测定，观察中西医结合治疗前后的变化，结果；４０例病人均存在在低Ｔ３、低Ｔ４和高ｒＴ３血症，且以重症病人最明显，Ｔ３水平低于０．５ｎｍｏｌ／Ｌ者病情危重，Ｔ４低于５０ｎｍｏｌ／Ｌ者预后不良；低Ｔ３、低Ｔ４和高ｒＴ３血症均随中西医结合有效治疗后     

人绒毛膜促性腺激素对早孕妇女甲状腺机能的影响

本文应用放射免疫（ＲＩＡ）和免疫放射（ＩＲＭＡ）方法对２０例早孕妇女的人绒毛膜促性腺激素（ｈＣＧ）水平进行研究，以求阐明是否ｈＣＧ具有垂体促甲状腺激素（ＴＳＨ）样作用的可能性。结果显示，甲孕妇女四碘甲状腺原氨酸（Ｔ４）和游离甲状腺素（ＦＴ４）水平升高，ｈＣＧ浓度与Ｔ４、ＦＴ４亦成正相关关系，然其三碘甲状腺原氨酸（Ｔ３）、游离三碘甲状腺原氨酸（ＦＴ３）水平却与正常对照组无明显差异。ｈＣＧ水平升高与Ｔ     

急性颅脑外伤围手术期甲状腺功能的临床研究

本文选择不同一种麻醉方法对急性颅脑外伤患者甲状腺功能变化进行临床观察。用全身插管麻醉对３０例（其中男性２０例，女性１０例）急性颅脑外伤患者于术前、插管麻醉后、术中、术毕、术后２４、术后４８小时等六个时相用放射免疫分析法动态测定血清ＴＳＨ、Ｔ３、Ｔ４、ｒＴ３、ＦＴ３、ＴＦ４、ＡＧＴ、ＭＣＡ变化值。结果表明：急性颅脑外伤男、女性别之间血清ＴＳＨ、Ｔ３、Ｔ４、ＦＴ３、ＦＴ４测值比较差异有显著性（Ｐ〈０．     

甲亢用^131I治疗前后动态检测甲状腺功能变化的临床研究

随访４０例Ｇｒａｖｅｓ病（ＧＤ）患者用＾１３１Ｉ（ＲＡＩ）治疗１年的情况,动态测定了治疗前后不同时期血清下丘脑垂体甲状腺相关激素浓度并泽其测定结果进行了统计学处理和临床分析。结果是：Ｔ３、Ｔ４、ｒＴ３、ＦＴ３、ＦＴ４血清浓度在治疗后１个月最高,治疗前次之,治疗５个月烈降至正常;ＴＳＨ在治疗前较低,治疗后１个月基本恢复正常,治疗５个月后稍高于正常;ＴＲＨ在治疗５个月后开始增高;ＡＴＧ、ＭＣＡ在治疗１     

hCG对葡萄胎患者甲状腺机能的影响

应用放射免疫和免疫放射方法测定１３例葡萄胎患者的ｈＣＧ水平及甲状腺功能。结果：Ｔ４、ＦＴ４水平升高，Ｔ３浓度较正常为高（Ｐ〈０．００１），少数病例ＦＴ３水平升高。葡萄胎组织清除后，Ｔ４、ＦＴ４、Ｔ３随ｈＣＧ水平下降而下降，ｈＣＧ浓度与三者之间成正相关关系。ｈＣＧ浓度与ＴＳＨ水平呈现镜像（ｍｉｒｒｏｒ ｉｍａｇｅ）关系。结果提示：在葡萄胎患者，其甲状腺功能亢进并非由垂体分泌的ＴＳＨ刺激所致，而是受到     

烧伤病人6项血清学指标联检的评价

甲状腺激素是参与机体代谢的重要内分泌激素 ,烧伤后机体内环境的变化往往导致这些激素的改变。近年来对烧伤病人血清三碘甲腺原氨酸（Ｔ３）、四碘甲腺原氨酸（Ｔ４）的检测价值已有较多研究 ,而对游离Ｔ３（ＦＴ３）、游离Ｔ４（ＦＴ４）、反Ｔ３（ｒＴ３）、高敏促甲状腺激素（ｓＴＳＨ）却很少报道。我院自１９９８年１０月～２０００年３月对４６例烧伤病人血清上述六项指标进行联合检测分析。本文将其价值探讨如下。资料和方法一、临床资料 ;烧伤病人４６例（男２９,女１７） ,年龄１５～７６岁 ;烧伤面积３～９５ % ,平均面积４６．…     

游离三碘甲状腺原氨酸酶免疫的分析

半三碘甲状腺原氨酸（Ｔ３）与β－Ｄ半乳糖苷酶联结，制成Ｔ３－酶联结物（Ｔ３－Ｅ）。用Ｔ３－Ｅ作为示踪剂建立了游离Ｔ３（ＦＴ３）酶免疫分析（ＥＩＡ）。本法灵敏度为０．２９ｐｍｏｌ／Ｌ，批内和批间变异系数分别为７．６％￣８．７％和７．８％￣１４．９％，与二碘甲状腺原氨酸（Ｔ２）、反Ｔ３（ｒＴ３）和甲状腺素（Ｔ４）的交叉反应率分别为９．７×１０＾－４、１．１×１０＾－４和３．１×１０＾－５。本法与ＦＴ３     

正常围产期妇女血、新生儿脐血FT3、FT4测定及临床意义

正常围产期妇女血、新生儿脐血ＦＴ_３、ＦＴ_４测定及临床意义解放军第１５９医院（４６３００８）薛芸香，万春岚，李秀兰，陈珍亮总三碘甲状腺原氨酸（ＴＴ３）、总甲状腺素（ＴＴ４）在作为孕产妇、新生儿甲状腺素功能测定时，往往不能反映具有生物活性的游离三碘甲状...     

测定甲状腺激素在判断重症病例预后中的价值

目的:通过测定重症疾病患者甲状腺激素(TH),判断其在病情严重程度及疾病预后中的价值.方法:把重症疾病分为三组,分别采用放射免疫分析(RIA)测定血清甲状腺激素进行对照,并作统计学处理.结果:与正常人组比较重症疾病组血清T3、FT3显著降低,rT3浓度升高,T4、FT4、TSH无明显变化.结论:非甲状腺疾病重症病例血清T3、rT3、FT3含量变化与疾病严重程度相关,激素含量在治疗中的变化预示疾病转归情况.     

新生儿脐血及不同孕期妇女血液中甲状腺激素综合测定在妇幼保健中的作用

目的 :探讨我区正常孕妇妊娠期间及新生儿血液中的甲状腺激素的水平和碘缺乏状态 ,为我区消灭新生儿碘缺乏症提供依据。方法 :利用放射免疫(或免疫放射)分析方法 ,对沂蒙山区300例正常孕妇不同孕期血液和2000例新生儿脐血中TT3、TT4、FT3、FT4、rT3、TSH进行综合检测和相关性研究。结果 :孕妇血清中TT3、TT4、FT3、FT4、rT3、TSH值均发生变化 ,以TT3、TT4、rT3、TSH变化较为显著(与孕前比较p<0.05或p<0.01),FT3、FT4 二者在妊娠期间变化较小 ,其值均在正常范围内。男女两性新生儿脐血中的甲状腺激素和促甲状腺激素无显著性差异 ,山区居民新生儿脐血中TT3、TT4、FT3、FT4、rT3 均低于、TSH高于城镇居民新生儿 ,TT3、TT4 之间存在显著性差异 (p<0.05);有6例(0.30 %)新生儿存在缺碘状况。山区居民孕妇血清中的甲状腺激素普遍较城镇居民偏低 ,未发现碘营养缺乏者。结论 :检测孕妇血清和新生儿脐血中FT3、FT4、TSH ,是判断孕妇、胎儿及新生儿是否存在碘缺乏重要依据。在孕期、婴幼儿期及时给予补碘治疗能有效地改善胎儿和新生儿缺碘状况。     

Establishment of reference intervals for thyroid- stimulating hormone and free thyroxine in amniotic fluid using the Bayer ADVIA Centaur

Thyroid hormone concentrations in amniotic fluid (AF) can aid in the diagnosis of fetal hypothyroidism. However, the availability of reference intervals for thyroid hormones in AF using current methods is limited. The purpose of this study was to validate the Bayer ADVIA Centaur (Bayer Healthcare, Tarrytown, NY) third-generation thyroid-stimulating hormone (TSH), total thyroxine (T4), and free thyroxine (FT4) assays for use with AF and establish reference intervals for these thyroid hormones in AF. Third-trimester AF samples were assayed for TSH, T4, and FT4. Reference intervals were calculated using nonparametric analyses. The reference intervals were as follows: TSH (n = 131), 0.04 to 0.51 microIU/mL (0.04-0.51 mIU/L), with a median of 0.10 microIU/mL (0.10 mIU/L); FT4 (n = 133), less than 0.10 to 0.77 ng/dL (1.29-9.93 pmol/L), with a median of 0.26 ng/dL (3.35 pmol/L). T4 in AF was undetectable using the Centaur assay, reinforcing the importance of validating different manufacturers' immunoassays for use with nonserum specimens. These reference intervals represent the first study performed to date using a third-generation TSH assay and a sensitive FT4 assay.     

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.     

Hypothalamic-pituitary-thyroidal dysfunctions in anorexia nervosa

There are clinical similarities between anorexia nervosa and hypothyroidism. Circulating levels of T4 and particularly T3 have been reported to be low in this eating disorder. Previous reports have, however, shown normal basal levels of serum TSH with normal or delayed responses to TRH. To assess thyroid function and the hypothalamic-pituitary axis in 21 women with anorexia nervosa, serum levels of free and total thyroid hormones, binding proteins, and TSH employing an extremely sensitive assay (detection limit = 0.02 microU/ml) were measured. Serum T4, free T4, T3, free T3, TSH, TBG and TBPA concentrations were significantly lower and rT3 levels were significantly higher in anorexia nervosa patients than in normal controls. A delayed TSH response to TRH was noted in 66% of patients, hyporesponsiveness was seen in another 24%, and a normal response in only 10%. In 10 anorexia nervosa patients studied after weight gain, T4, T3, free T3, TSH, TBG and TBPA were significantly increased, and rT3 was significantly decreased. No change in mean free T4 levels with weight gain was noted. Other parameters of hypothalamic dysfunction in anorexia nervosa have been reported and the present data suggest that apparent hypothalamic hypothyroidism occurs perhaps as an adaptation to prolonged starvation.     

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。     

Thyroid function tests

About 80% of thyroid disease consists of thyroid-specific autoimmune diseases, Hashimoto's disease and Grave's disease. To diagnose thyroid diseases, testings for (1) thyroid function and (2) pathogenetic autoantibodies are indispensable. To assess thyroid function, serum hormone concentrations, such as TSH, FT4 and FT3 are measured. Among these hormones, serum TSH concentrations are the most reliable and informative regarding thyroid function, correcting indicating a hyperthyroid, euthyroid or hypothyroid state. Therefore, TSH measurement appears to be the first choice in selecting the hormone determination. Reference intervals for normal healthy subjects of TSH are around 0.4-5.0 microU/ml. The second choice for thyroid function assessment are FT4 which supersedes total T4(TT4). TT4 is affected by changes in serum thyroid hormone binding proteins(TBG, TTR, Albumin). For example, euthyroid pregnant women whose serum TBG are physiologically higher than those of non-pregnant women show augmentation of TT4. However, FT4 depicts within reference intervals, although measurement of FT4 alone is unable to detect any abnormality of thyroid hormone binding proteins. According to its plasma concentration and binding affinity, FT3 measurement deserves no more significance than T3. Another important test for thyroid diseases is to detect serum autoantibodies against thyroid tissues, such as TgAb, TPOAb. Much more important is TSH receptor antibody which differentiates Graves' disease from Hashimoto's thyroiditis. In patients who show hyperthyroidism and some very uncommon hypothyroidism, TSH receptor antibodies should be measured. Three indicators are available as routine tests; TRAb measured by radioreceptor assay; TSAb determined by bioassay using cultured porcine thyroid cells. Usually, TRAb activity clinically correlates well with TSAb. TSBAb was initially discovered in patients with severe hypothyroidism with atrophic thyroid gland. TSBAb blocks thyroid stimulating activity of TSH and consequently causes severe hypothyroidism. TRAb and TSAb are very useful to diagnose and follow patients with Grave's disease.     

老年急性阑尾炎围手术期血清甲状腺激素及TSH水平的观察

目的:探讨老年急性阑尾炎围手术期甲状腺激素及TSH水平的变化规律及其临床意义。方法:选择我院67例老年急性阑尾炎患者,分别于手术前、手术后1d、3d、5d、7d、14d取空腹静脉血,应用放射免疫分析检测FT3、FT4、T3、T4、rT3及TSH水平,同时分析甲状腺激素及TSH水平与临床病理分型、并发症的关系。结果:该病患者均存在不同程度的低FT3、FT4、T3、T4血症和高rT3血症,且以坏疽性和穿孔性阑尾炎最明显。这种现象均于术后7d恢复正常。结论:老年急性阑尾炎患者甲状腺内分泌功能均受到不同程度的抑制,围手术期动态观察FT3、FT4、T3、T4、rT3血液激素水平,有助于病情轻重的判断、临床病理的初步分型,有利于临床治疗方案的制定。     

血清TSH和Hcy测定在甲状腺功能减退诊断中的价值

目的 分析血清甲状腺激素（TH）和同型半胱氨酸（Hcy）水平测定在甲状腺功能减退诊断中的价值。方法 选取2018年2月~2019年2月在我院诊治的50例甲状腺功能减退患者设为观察组A,40例亚临床甲状腺功能减退患者设为观察组B,另选同期体检正常者40例设为对照组。分别检测三组TH[三碘甲状腺原氨酸（T3）、甲状腺素（T4）、促甲状腺素（TSH）]、Hcy水平并进行比较。结果 观察组B血清FT3、FT4水平与对照组比较,差异无统计学意义（P＞0.05）,血清TSH、Hcy水平高于对照组（P＜0.05）;观察组A血清FT3、FT4水平低于对照组,血清TSH、Hcy水平高于对照组（P＜0.05）;观察组A血清FT3、FT4水平低于观察组B,血清TSH、Hcy水平高于观察组B（P＜0.05）;血清TSH、Hcy变化与临床甲状腺功能减退呈正相关（P＜0.05）;血清TSH、Hcy诊断甲状腺功能减退敏感度和特异度均高于FT3、FT4诊断（P＜0.05）。结论 动态监测血清TSH、Hcy 水平,对亚临床甲状腺功能减退向临床甲状腺功能减退转化具有一定的诊断价值。     

血清TSH和甲状腺激素水平与乳腺癌关系的探讨

目的:探讨乳腺癌患者TSH和甲状腺激素水平的变化及其意义。方法:采用放射免疫分析和微粒子化学发光免疫分析检测了80例乳腺癌患者和100例健康对照者的血清T3、T4、TSH及rT3的含量。结果:乳腺癌患者血清T3水平和T3/rT3比值显著低于健康对照组,且随病情的加重逐渐下降,各组间经统计学比较均有显著性差异(P<0.01)。与此相反,血清rT3水平则显著地高于健康对照组,与病损程度呈正相关(P<0.01)。各组间血清T4、TSH水平与健康对照组比较无明显差异(P>0.05)。结论:测定血清T3、rT3浓度有助于乳腺癌患者病情严重程度和预后的判断。