甲状腺功能异常患者甲状腺状态对血浆脂联素的影响

目的 通过检测甲亢、甲减个体的血浆脂联素水平,探讨甲状腺功能异常时这种激素是否参与内环境的改变.方法 选取甲状腺功能异常者,分为甲状腺功能亢进组(甲亢组n=47)、甲状腺功能减退组(甲减组n=23),及甲状腺功能正常者(对照组n=50).取空腹血检测血糖(FPG)、胰岛素(FIN)、血脂、及脂联素,并计算体重指数(BMI)低密度脂蛋白-胆固醇及胰岛素抵抗指数.结果 甲亢组脂联素水平显著高于对照组及甲减组(11.78±0.64) vs (7.73±0.23),(6.89±0.29)μg/mL,(P＜0.01～P＜0.001);脂联素与游离T3、游离T4、FIN及胰岛素抵抗指数呈正相关,与BMI、三酰甘油(TG)及总胆固醇(TC)呈负相关.结论 甲状腺功能异常患者存在血浆脂联素水平的变化,这些变化与甲亢时能量的消耗及甲减时能量的储备现象有关.     

Beta-adrenoreceptor blocking drugs and thyroid hormones in hyperthyroid subjects.

Serum thyroid hormone concentrations were measured before and during 10 days'' treatment with atenolol (200 mg/day), acebutolol (400 mg/day), oxprenolol (160 mg/day) and propranolol (160 mg/day) in 24 hyperthyroid patients. During propranolol treatment serum triiodothyronine (T3) concentrations fell significantly (P less than 0.05) but there was no change in thyroid hormone concentrations in the other groups although all patients reported a symptomatic improvement.     

Glycemic status in women using combined oral contraceptive pill

This study was undertaken to determine the effects of low-dose combined oral contraceptives(OCs) containing 30 gm Ethinyl estradiol with 150 microg Levonorgestrel on carbohydrate metabolism by a glycaemic variable -- fasting blood glucose level. It is now known that impairment of carbohydrate metabolism is a potential risk factor for cardiovascular disease and other metabolic disorder. Sixty women age between 15-35 years using OCs served as experimental group and thirty age matched hormonal contraceptive non users were selected for control group. Experimental group was again subdivided into OCP (Oral contraceptive pill) users for last one year group, three year group and five year group. The result showed that there were no significant differences on blood glucose level between users and non-users women. It is concluded that the cyclic administration of monophasic low dose OCs did not altered blood glucose levels and there by have no additional adverse impact on women health reaffirming the ongoing oral contraceptive pill distribution program.     

甲状腺机能亢进性心脏病X线表现分析

目的：探讨甲状腺机能亢进性心脏病（以下简称甲亢性心脏病）的X线表现分析与诊断。方法：对临床上诊断的51例甲亢性心脏病患者均拍摄胸部正、侧位平片,其中19例同时行胸部透视,观察心脏形态的改变、心脏及大血管的搏动情况,分析肺循环改变。经过测量心胸比率观察心脏各房室的增大。12例做了心脏B超。结果：X线表现：心脏增大占78．6％,多数为轻－中度增大（74．4％ ）。心脏各房室增大,以右心室增大者为多数,其次有左、右心室增大及左室增大。心脏形态以二尖瓣型心脏为多,占80．4％,其次表现为主动脉型及二尖瓣－普大型心脏。肺动脉段突隆,心脏及肺动脉搏动增强。结论：甲亢性心脏病在X线片上有一定的特征性改变,但确定诊断必须紧密结合临床及其他检查资料,并与先天性房间隔缺损、肺心病、风湿性心脏病进行鉴别。     

重症患者的血糖变异性

自第一次强化胰岛素治疗能降低外科重症患者的死亡率被报道以来,降低血糖水平被推荐为能改善患者预后的一种方法.然而,关于ICU患者强化胰岛素治疗的更新的多中心随机对照研究得到不一致的结果.最近一些国外研究已经证实血糖变异性和患者预后的显著相关性.目前国内对血糖变异性这一领域的研究几乎是空白,就血糖变异性的研究现状作一综述.     

罗汉参血糖生成指数的测定分析

目的测定罗汉参和南瓜的血糖生成指数(GI),并与其他高碳水化合物食物的GI值进行比较,探讨产生差异的可能原因。方法采用交叉实验法,空腹健康志愿者分3次食用葡萄糖粉、罗汉参和南瓜,每种食物间隔72?h,测定空腹血糖和餐后2h血糖水平,绘制血糖应答曲线。结果以葡萄糖GI值为100,罗汉参和南瓜的GI值分别为48.87±0.06、78.75±0.11。食用罗汉参和南瓜后血糖峰值均出现在45?min,罗汉参的血糖应答曲线下增值面积明显低于葡萄糖粉和南瓜（P＜0.05）,南瓜的血糖应答曲线下增值面积明显小于葡萄糖粉（P＜0.05）。结论罗汉参为低GI食物,南瓜为高GI食物,罗汉参的餐后血糖水平低于南瓜等高碳水化合物食物,可能是由于罗汉参淀粉中抗性淀粉含量较高（77.31%）所致。     

Recurrent episodes of arthritis in a hyperthyroid patient

Antineutrophil cytoplasmic antibody (ANCA)- associated vasculitis is a potentially life-threatening adverse effect of antithyroid medications. We present a 22-year-old woman with Graves' disease who developed recurrent episodes of arthritis while on treatment with propylthiouracil. A diagnosis of propylthiouracil-induced ANCA-associated vasculitis was established only after exhaustive rheumatological investigations failed to establish a cause for her arthritis. Anti-myeloperoxidase antibody (anti-MPO) titres were grossly elevated at 172.7 RU/mL (0-20). Her arthritis resolved promptly following the withdrawal of propylthiouracil and the anti-MPO titres declined over 16 months to 66.8 RU/mL. While she did not develop the life-threatening renal or respiratory tract complications, there was a delay in establishing the correct diagnosis with its attendant morbidity. This case highlights the need for greater awareness of this relatively rare adverse effect of antithyroid medications so as to allow its early detection, leading to the prompt cessation of the offending medication.     

Bone status assessment in Japanese subjects using speed of sound along the tibia

Ｃｌｉｎｉｃａｌｌｙａｖａｉｌａｂｌｅｍｅｔｈｏｄｓｏｆｂｏｎｅｄｅｎｓｉｔｏｍｅｔｒｙ ,ｓｕｃｈａｓｄｕａｌ ｅｎｅｒｇｙＸ ｒａｙａｂｓｏｒｐｔｉｏｍｅｔｒｙ (ＤＥＸＡ) ,ａｎｄｑｕａｎｔｉｔａｔｉｖｅｃｏｍｐｕｔｅｄｔｏｍｏｇｒａｐｈｙ ,ｍｅａｓｕｒｅｔｈｅｏｎｌｙｑｕａｎｔｉｔａｔｉｖｅｖａｌｕｅｓｏｆｂｏｎｅｍｉｎｅｒａｌｄｅｎｓｉｔｙ (ＢＭＤ) Ｈｏｗｅｖｅｒ ,ｑｕａｌｉｔａｔｉｖｅｆａｃｔｏｒｓ,ｌｉｋｅｅｌａｓｔｉｃｉｔｙ ,ｆａｔｉｇｕｅｄａｍａｇｅ ,ａｎｄｍｉｃｒｏａｒｃｈｉｔｅｃ…     

甲亢性心脏病肺循环血流动力学研究

目的：探讨甲亢性心脏病（甲亢心）病人肺循环血流动力学变化，方法：将24例甲亢心患按病程不同分为治疗前组（10例），恢复期组（8例）和临床治愈组（6例），采用多导心电检测与压力传感记录系统，血气分析仪，右心微导管及肺量仪分别描计各部位的压力波形及压力，再根据Fick氏公式计算心排血量（CO），再分别计算心脏指数（CI），每搏指数（SVI）及肺循环血流阻力（PVR），结果：甲亢心患治疗后肺动脉压（PAP），肺循环阻力（PVR），右心室压力（RVP），右心房压（RAP），中心静脉在（CVP），CO，CI和SVI能恢复到正常水平，恢复期组和临床治愈组血清甲状腺激素各项指标（TT3，TT4，FT3，FT4）较治疗前有明显降低（P＜0．01），结论：肺动脉高压的形成与肺血管紧张性增加有关，其机理可能与甲状腺激素促进肺循环血管紧张素Ⅱ，心房利钠肽（ANP），或其他血管收缩因子分泌增加有关，而FT3，FT4可作为反映甲亢心肺循环血流动力学改变的间接指标。     

131I治疗甲状腺机能亢进的护理体会

0 引言我科2002-11/2003-03,经131I治疗甲状腺机能亢进(甲亢)合并多种并发症,取得满意效果. 　　……     

妊娠合并甲状腺功能亢进性心脏病病例报告及分析

目的 探讨妊娠合并甲状腺功能亢进性心脏病的处理原则.方法 采用回顾性研究方法,报告2例妊娠合并甲状腺功能亢进性心脏病患者,并对病案进行讨论与分析.结果 未经过系统治疗的妊娠合并甲亢,其合并重度子痫前期、甲亢性心脏病的发生率高,危险性高,治疗困难.结论 妊娠甲亢性心脏病在甲状腺功能控制不满意但需积极终止妊娠时,可在服用大剂量丙基硫氧嘧啶同时服用碘剂,使甲状腺功能在短时间内控制满意,但术后应及时减量.治疗时强调多学科合作.     

Coagulation profiles in hypothyroid and hyperthyroid female patients in Sudan

OBJECTIVE: To evaluate disturbances in the coagulation system in female patients with thyroid disorders in order to assess the effects of thyroid diseases on coagulation parameters. METHODS: This study was conducted in Khartoum state, the national capital of Sudan from February 2007 and February 2008 The study included 30 patients with clinical hypothyroidism, and 30 patients with sub- clinical hypothyroidism (21 of them were recruited before starting the treatment). Also, the study included 30 patients with clinical hyperthyroidism, 30 with sub-clinical hyperthyroidism, (37 of them were recruited before starting the treatment) and 30 normal individuals as the control group. Prothrombin time (PT), activated partial thromboplastin time, fibrinogen level, and platelets count were performed in patients and control samples. RESULTS: A significantly decrease in PT was observed in hypothyroid patients, and hyperthyroid patients compared to the control group. Activated thromboplastin time was significantly decreased only in hyperthyroid patients, compared to the control group. Moreover, fibrinogen level was significantly increased in hyperthyroid patients compared to hypothyroid patients. CONCLUSION: The study concluded that minor coagulation abnormalities were observed in both subclinical hypo- and hyperthyroidism compared to clinical hypo- and hyperthyroidism. Platelets count was also slightly decreased in both types of the disease. There was no significant effect of the treatment and age of such patients on the measured parameters. The study recommended to screen female patients with hypo- and hyperthyroidism for coagulation defect, to avoid the risk of such complications.     

甲状腺机能亢进性心脏病的诊断和治疗

目的 探讨甲状腺机能亢进性心脏病的诊断和治疗方法。方法 回顾总结1995年5月～2003年5月共收治的甲亢性心脏病21例的临床资料。结果 心房纤颤、频发早搏、阵发性室上性心动过速、房室传导阻精和心房扑动术后3个月全部消失，心力衰竭术后3个月明显改善。结论 诊断甲状腺机能亢进性心脏病应在确诊甲亢后，具有一项或多项心脏病症，且排除其它原因的心脏病。治疗甲亢性心脏病应以控制甲亢症状为根本措施，积极采取手术治疗方可治愈。     

糖尿病微血管并发症及血糖控制

1 糖尿病并发症的发生率血糖控制虽然是2型糖尿病治疗的核心,但是从长远观点看,延缓糖尿病并发症的发生只控制血糖是不够的。虽然已进入21世纪,但是人们依然被糖尿病晚期并发症所困扰。糖尿病仍然是成人致盲的主要原     

甲状腺功能亢进性心脏病52例的临床分析

目的探讨甲状腺功能亢进性心脏病（甲亢心）的临床特点,以提高甲亢心的防治经验。方法本研究对我科2006年1月~2009年10月收治的52例甲亢心患者临床资料进行回顾性分析。结果甲亢心多数发生于其病程较长,本组患者心律失常44例（84.6%）,心脏扩大38例（73%）,心力衰竭36例（69.2%）,误珍8例（15.3%）。结论甲亢心临床表现多种多样,对原因不明的心律失常,心力衰竭及心脏扩大的患者应常规筛查甲状腺功能,早期发现和诊断,以防止误诊和漏诊。     

阿仑膦酸钠对甲亢并骨质疏松患者的疗效分析

目的观察阿仑膦酸钠对青壮年（20—40岁）甲亢患者骨密度（BMD）的影响。方法选择正常健康志愿者30例作为正常对照组（B组）,腰椎骨密度低于健康年轻女性减1．0—2．0标准差的青壮年（20—40岁）甲亢患者共76例,随机分为2组,抗甲亢药治疗组（A1）38例,服抗甲亢药;抗甲亢药加阿仑膦酸钠治疗组（A2）38例,在服抗甲亢药基础上加服阿仑膦酸钠5mg／d。两组共服药12个月。结果抗甲亢药加阿仑膦酸钠治疗组A2组腰椎、股骨颈及大粗隆的骨密度均明显升高（P〈0．05）,其中腰椎骨密度治疗前为（0．91±0．09）g／cm2,治疗后12个月达到（1．11±0．07）异／cm2,增加率为30．6％,明显高于A1组（P〈0．05）。12个月治疗总有效率A2组为61．2％,显著高于A1组的31．6％（P〈0．05）。患者无严重副作用。结论阿仑膦酸钠能明显提高甲亢患者的骨密度．副作用轻。