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.     

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.     

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。     

Effects of long-term administration of theophylline on the pituitary-thyroid axis in asthmatics

The effects of long-term administration of theophylline on the pituitary-thyroid axis were investigated. In the first study, the changes in serum thyroid hormone, TSH and cortisol levels were examined before and after 2 week-administration of sustained-release theophylline in 5 normal and 10 asthmatic subjects. In the normal subjects, the hormone levels did not change before or after theophylline administration. On the other hand, in the asthmatics, serum TSH levels increased (p less than 0.05) and serum free T3 levels decreased (p less than 0.05) after 2 weeks. In the asthmatics, basal T4 levels had a significant correlation with both basal T3 and rT3 levels, but T4 levels after 2 weeks correlated significantly with rT3 alone. In the second investigation, the effects of long-term administration were studied in 15 asthmatics not on theophylline (group 1), 20 asthmatics on theophylline (group 2), and 20 asthmatics on theophylline and glucocorticoids (group 3). TSH levels in group 2 were significantly higher than those in groups 1 and 3. Although in group 1 there was a significant correlation between T4 levels and T3 and rT3 levels, in group 2 T4 levels correlated significantly with rT3 levels alone. In conclusion, these results suggest that although long-term theophylline treatment may increase the secretion of TSH from the pituitary in asthmatics, in the peripheral tissue it may decrease the conversion of T4 to T3, resulting in the diminution of active hormones.     

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。     

The TRH stimulation test and reverse T3 in depression

Blunted TSH response to TRH and elevation of reverse T3 (rT3) have been reported in depression, though the relationship between these two abnormalities has not been clear. The authors measured basal levels of T4, T3, rT3 and the TSH response to TRH in a group of 28 depressed men and women, unipolar and bipolar subtypes. No significant difference was found between these two subtypes of depression with respect to mean basal hormonal levels or magnitude of the TSH response to TRH. Two males had slight, but significant elevations of rT3 though only one of them had a blunted TSH response to TRH levels and the TSH response to TRH. Finally no significant correlation was found between rT3 levels and the TSH response to TRH.     

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.     

体外循环时间CPB与心外科手术患者围手术期血清FT3、FT4、TSH、rT3水平的相互关联研究

目的 分析体外循环时间CPB与心外科手术患者围手术期血清FT3、FT4、TSH、rT3水平的相互关联研究.方法 选取就诊手术的心外科患者102例进行研究,并根据CPB时间不同分为短时组;中等时间组以及长时组(2.0h及以上).对三组患者围手术期血清FT3、FT4、TSH、rT3水平进行分析讨论;使用SPSS软件分析数据.结果 与术前比较术后三组患者FT3水平均有所减低(P＜0.05);三组患者术后FT3水平比较提示,短时组水平在三组中相对最高,长时组水平相对最低(P＜0.05).对比FT4水平,与FT3情况近似;术前与术后三组患者的rT3水平,术后可见rT3水平均有所增高(P＜0.05);三组患者术后rT3水平比较提示,短时组水平在三组中相对最低,长时组水平相对最高(P＜0.05).经相关分析还发现,三组患者术后的FT3与FT4正相关,FT3与rT3以及FT4与rT3均负相关.结论 术后患者FT3、FT4水平均受影响而有所减低,且CPB历时越久减低越多,亦即甲状腺功能受到的影响越大.rT3水平的变化规律则正相反.     

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。     

羊水中甲状腺激素检测及其临床应用

采用体外放射分析方法对２２例正常和３０例正在治疗的患甲状腺疾病的孕妇羊水Ｔ３、Ｔ４、ＴＳＨ、ｒＴ３及ＦＴ３、ＦＴ４进行了测定。并监测孕妇妊娠期甲状腺功能和进行了新生儿甲低筛查。结果表明羊水中甲状腺激素水平的测定,对了解母体服药对胎儿的影响及有无胎儿甲低是有价值的。羊水中ｒＴ３水平的测定可作为观察及筛选胎儿甲低的方法之一。     

Total and free thyroid hormone levels in chronic renal failure.

The levels of serum total thyroxine (TT4), triiodothyronine (TT3), free T3, (FT3) free T4 (FT4) and thyrotropin (TSH) were measured in 127 clinically euthyroid patients with varying grades of chronic renal failure (CRF); and 97 healthy individuals. They were grouped as: Group I containing 93 patients on conservative management; Group II containing 34 patients on regular dialysis therapy; and Group III (normals). Group I patients showed significant decrease in TT3, TT4 and FT3 levels (p less than 0.001) as compared to Group III, whereas FT4 and TSH values in group I were not significantly altered. TT3, TT4 and FT3 levels reduced as the severity of renal damage increased. Variations in TT3, TT4, FT3, FT4 and TSH levels in Group II patients were similar to those in Group I, except for a decrease in TSH levels (p less than 0.05) as compared to normals. Several thyroid function tests are abnormal in CRF patients, however, finding of normal FT4 and TSH levels would indicate functional euthyroid status.     

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.     

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。     

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     

Thyroid-Stimulating Hormone Is Significantly Associated with Bone Health Status in Men

Background and Aim: Recent studies revealed a novel association between thyroid-stimulating hormone (TSH) and bone health status in healthy male populations. The present study aimed to validate this association and provide new information on the relationship between TSH levels and calcaneal speed of sound (SOS) in men.Methods: This cross-sectional study recruited 681 men with complete data of calcaneal SOS, body anthropometry, serum TSH, free triiodothyronine (FT3) and free thyroxine (FT4) levels.Results: All subjects had FT3 and FT4 levels within the in-house reference range and 13 subjects had lower than normal TSH levels. The results revealed that the SOS value of subjects was significantly associated with TSH after multiple adjustments (p<0.05). When subjects were divided into quintiles according to their TSH levels, the difference of SOS between men with low-normal TSH and high-normal TSH contributed significantly to the association between TSH and bone health status (p<0.05). The significance of the association persisted with the inclusion and exclusion of subclinical hyperthyroid subjects.Conclusions: There was a significant association between TSH levels and bone health status in men as assessed by quantitative ultrasound. This age-independent association between TSH and SOS might explain some of the individual variation of bone health status in men.     

The effects of dieting and weight loss upon the stimulation of thyrotropin (TSH) by thyrotropin-releasing hormone (TRH) and suppression of cortisol secretion by dexamethasone in men and women

The effects upon basal hormone levels and neuroendocrine responses of a weight reducing diet allowing 1200 kcal daily were determined in male and female volunteers. Thyrotropin (TSH) responses to thyrotropin-releasing hormone (TRH) were unchanged in men but attenuated in women; this effect was associated with a fall in basal TSH in women, not in men. Rates of non-suppression of cortisol in response to oral dexamethasone (1 mg) were unchanged during dieting although basal morning cortisol levels rose in males and females. The implications for the use of the TRH test and the dexamethasone suppression test (DST) in depressive illness are discussed.     

原发性肝癌患者手术前后血清T3、T4、FT3、FT4、rT3、sTSH检测的临床意义

目的:探讨原发性肝癌患者手术治疗前后血清甲状腺素水平的变化及意义.方法:应用放免法检测了36例原发性肝癌患者手术治疗前后血清T3、T4、FT3、FT4、rT3、sTSH含量的变化,并与35名正常健康人作比较.结果:原发性肝癌患者在手术前血清T3、T4、FT3水平显著地低于正常人组(P＜0.01),而rT3水平则显著地高于正常人(P＜0.01),FT4、sTSH水平无变化(P＞0.05),经手术治疗后6个月血清后T4、FT3仍低于正常人组(P＜0.05),而rT3水平与正常人比较无显著性差异(P＞0.05).结论:测定原发性肝癌患者手术治疗血清T3、T4、FT3、rT3水平的变化与患者的病情和愈后密切相关,有一定的临床价值.     

Sex steroid replacement in post-menopausal women: effects on thyroid hormone status

We have measured serum thyroxine (T4), triidothyronine (T3), thyroid-stimulating hormone (TSH) free thyroxine (FT4) and thyroxine-binding globulin (TBG) levels in a total of 5 post-menopausal women who were receiving oestrogen alone (Premarin, n = 19), progestogen alone (Primolut-N, n = 12), a combination of oestrogen and progestogen (Prempak C, n = 14) or no treatment (control group, n = 12). No differences were observed between the Premarin and Prempak C groups; both exhibited elevated T4 and TBG levels, although free thyroxin (FT4) and T4/TBG concentrations were normal relative to those in the control group. The Primolut-N subjects showed subnormal T3 and FT4 levels relative to the controls. It was concluded that it is not possible to make general statements regarding the effects of sex steroids on FT4 levels.     

脑血管疾病患者血清甲状腺激素水平检测的临床意义

目的 通过大样本研究了解不同类型脑血管疾病患者甲状腺激素水平的变化.方法 选取4496例脑血管疾病患者,包括脑出血患者1060例、脑梗死患者3145例、头颈部动脉狭窄患者25例、短暂性脑缺血发作(transient ischemicattack,TIA)患者266例,另外选取2516名健康体检者为对照组,采用化学发光免疫分析方法,检测血清中FT3、FT4、T3、T4、TSH水平.结果 脑血管疾病患者与对照组相比,FT3、FT4、T3、T4、TSH在两组之间的差异均有统计学意义.脑血管疾病患者血清FT3、T3、T4、TSH水平低于对照组,FT4高于对照组.将脑血管疾病患者进一步分为脑出血组、脑梗死组、头颈部动脉狭窄组及TIA组等4组,与对照组一起比较,FT3、FT4、T3、T4、TSH在5组之间的差异均有统计学意义.FT3、T3、TSH在各组中位数均为脑出血组＜脑梗死组＜头颈部动脉狭窄组＜TIA组,FT4在各组中位数为脑出血组＞脑梗死组＞TIA组＞头颈部动脉狭窄组,T4在各组中位数为脑出血组＞脑梗死组＞头颈部动脉狭窄组＞TIA组.结论 甲状腺激素水平变化可反映不同类型脑血管患者病情严重程度,是辅助诊断的重要指标.     

正常甲状腺功能病态综合征FT3、FT4和TSH与老年性疾病相关性研究

目的 通过测定血清游离FT3、FT4和TSH含量,探讨不同疾病组老年患者甲状腺功能状况.方法 用化学发光法测定我院226例老年患者血清FT3、FT4和TSH水平,并进行统计分析.结果 FT3、FT4和TSH测定结果分别为2.19pg/mL(中位数,P2.5～P97.5:1.00～3.12pg/mL)、1.01 ng/dL(中位数,P2.5 ～ P97.5:0.67 ～ 1.44ng/dL)和1.44μIU/mL(中位数,P2.5 ～ P97.5:0.28 ～4.92μIU/mL),FT3和FT4降低发生率分别为31.86％和3.54％,TSH增高发生率为3.10％.不同性别老年患者FT3、TSH差异具有统计学意义,而FT4差异无统计学意义.FT3、FT4和TSH异常发生率在两性之间差异均无统计学意义.FT3和FT4水平在不同疾病组之间差异显著,TSH在不同疾病组之间差异无统计学意义.FT3和TSH异常发生率在不同疾病组之间差异显著,FT4异常发生率在不同疾病组之间差异无统计学意义.结论 在老年性疾病患者中正常甲状腺功能病态综合征甲状腺功能异常发生主要为FT3降低.