甲状腺激素水平与新生儿硬肿症关系的研究

目的 了解新生儿甲状腺激素水平低下与硬肿症发生的因果关系及影响因素.方法 采用放射免疫法对具有低体温、低体重、反应差、心脏抑制等表现、但未发生硬肿的16名早产儿甲状腺激素(T4、T3、rT3、TSH)水平进行追踪性监测,并观察病程中发生新生儿硬肿症的情况.结果 观察对象中,100%小儿T3低于同期小儿甲状腺激素正常低限值,T3、T4同时降低者为93.8%;若以临床实验诊断标准低限值衡量,T3降低者为81.7%,T3、T4同时降低者为25%.其中T3降低者中84.6%在病程中发生了新生儿硬肿症,而T3未降低的患儿均未发生硬肿症.结论 甲状腺激素水平降低,特别是T3水平的严重降低可能是新生儿硬肿症的重要发病原因.     

Hormones and health outcomes in aging men

Increasing age is a predictor of ill-health and mortality related to cardiovascular disease and to frailty, a syndrome characterized by deterioration of multiple organ systems leading to loss of physiological reserve, diminished capacity to cope with stressors, and increased risk of disability and death. As men grow older, their levels of testosterone decline while the prevalence of ill-health increases. Observational studies have linked lower testosterone levels with cardiovascular disease and mortality in middle-aged and older men. More recently, lower testosterone has been shown to predict reduced sexual activity and frailty in aging men. Additional studies are needed to determine whether lower testosterone is a biomarker or a potentially treatable risk factor for poorer health outcomes in older men. During aging, the response of the pituitary–thyroid axis alters to manifest higher thyrotropin levels. The presences of subclinical hypo- and hyper-thyroidism predict adverse cardiovascular outcomes. Newer results indicate that in euthyroid older men, differences in free thyroxine levels within the normal range predict specific health outcomes including frailty. Clarification of the roles of endogenous testosterone and thyroxine in the genesis of ill-health during male aging offers the prospect of future intervention to preserve health and well-being in this growing population.     

健康老年人与老年期痴呆患者血清甲状腺激素及促甲状腺激素的变化

Inordertoinvestigateperipheralthyroxinemetabolismandpi－tuitary－thyroidaxisfunction，changesofserumT３，T４，andTSHinhealthyeldersanddementiaseniorsandtheirrelatioship，wemea－suredserumT３，T４andTSHin５０eldersolderthan８０yearsand３１dementiaelders．Hereisthereport．１Subjectandmethod１．１Subject５０healthyeldersconsistingof３８malesand１２femalesaged８０～９３，meanage（８４．７６±３．９６），wereincludedineldersgroup．Allsubjectshadnohistoryofheart，brainandkidneydiseasesandwereacc…     

慢性肾功能衰竭患者血清三碘甲状腺原氨酸、甲状腺素和促甲状腺激素含量的变化及临床意义

目的：探讨慢性肾功能衰竭（ＣＲＦ）患者血清三碘甲状腺原氨酸（Ｔ３）、甲状腺素（Ｔ４）和促甲状腺激素（ＴＳＨ）水平的变化及其临床意义。方法：采用放射免疫分析法测定６６例ＣＲＦ患者血清Ｔ３、Ｔ４和ＴＳＨ的含量，并与３０例正常人作对照分析。结果：ＣＲＦ患者失代偿期血清Ｔ３、Ｔ４水平随血尿素氮（ＢＵＮ）、肌酐（Ｃｒ）的升高而渐降低，与对照组比较均有显著性差异（Ｐ均＜０．０５）；ＴＳＨ与血ＢＵＮ和Ｃｒ的升高无关，治疗后Ｔ３、Ｔ４水平随病情好转而渐升高（Ｐ均＜０．０５）。结论：血清Ｔ３、Ｔ４水平可作为判断ＣＲＦ病情、观察药物疗效和预后的指标。     

高血压脑出血甲状腺功能异常患者再出血及预后的观察

目的 探讨高血压脑出血(HICH)甲状腺功能异常患者再出血的发生与预后情况.方法 纳入盐城市亭湖区人民医院2014年5月至2019年5月收治的HICH甲状腺功能异常患者80例.根据患者是否发生再出血,分成再出血组14例、未再出血组66例.比较两组甲状腺功能指标,包括促甲状腺激素(TSH)、总甲状腺素(TT4)、总三碘甲...     

Appropriate Replacement Dose of Thyroxine in Primary Hypothyroidism

ABSTRACT An ultrasensitive thyrotropin (TSH) assay was used to determine how many of 65 patients with primary hypothyroidism on thyroxine (T₄) replacement therapy had suppressed serum TSH. In 13 patients (20%) TSH levels ≤0.1 mlU/l were found, indicating an overdose of thyroxine. After correction of the dose, 48 patients had normal TSH values. Their mean dose of thyroxine was 119 μg/24 hours, and the appropriate replacement dose tended to decline with advancing age. The serum level of thyroid hormones during replacement therapy with thyroxine very imperfectly reflected serum TSH values. It is concluded that overdose of thyroxine is common when suppressed serum TSH is used as an end point. Biochemical follow-up of replacement therapy with thyroxine in primary hypothyroidism therefore requires the use of an ultrasensitive TSH assay in order to detect such suppression. Serum levels of thyroxine or triiodothyronine (T₃) during thyroxine therapy are poor indicators of pituitary TSH secretion and are therefore not useful as parameters of adequate thyroxine dosage.     

不同孕期女性血清中人绒毛膜促性腺激素与促甲状腺激素水平相关性分析

目的 研究不同孕期女性人绒毛膜促性腺激素(HCG)和促甲状腺激素(TSH)的相关性。方法 本研究随机选取2018年10月至2020年6月杭州市妇产科医院产科门诊就诊的150例妊娠期女性作为研究对象,根据妊娠期不同,分为妊娠早、中、晚期各50例,对比三组孕妇HCG、TSH、游离甲状腺素(FT4)的水平、分析不同孕期HCG、TSH和FT4的相关性、比较不同孕期甲减发生率。结果 妊娠晚期女性TSH水平最高,其次是妊娠中期和早期,妊娠晚期女性HCG和FT4水平最低,其次是妊娠中期和早期,组间比较差异有统计学意义(P0.05)。不同妊娠期甲减发生率为2.0%～6.0%,组间比较,差异无统计学意义(P0.05)。经Pearson相关性分析显示,妊娠晚期孕妇HCG水平均与FT4水平呈正相关(r=0.311,P=0.028),不同妊娠期孕妇HCG水平均与TSH水平呈负相关(r=-0.103,P=0.048;r=-0.111,P=0.044;r=-0.149,P=0.030)。结论 随着妊娠周期的增加,HCG水平逐渐降低,而TSH水平持续升高,FT4分泌减少,可能会增加甲状腺功能发生紊乱的风险。因HCG可对垂体-甲状腺轴产生一定影响,故可根据HCG变化水平定期检查甲状腺功能,从而有效预防或改善不良妊娠结局,以确保孕妇及胎儿健康,对临床合理干预具有较高价值。     

甲状腺功能减退症患者甲状腺素治疗对血脂、血液流变学的影响

目的探讨甲状腺功能减退症（简称甲减）患者给予甲状腺素替代治疗前后血脂及血液流变学等的变化。方法选择36例临床甲减患者及40例正常对照组,检测血清游离T3（FT3）、血清游离T4（FT4）、血清促甲状腺素（TSH）、血脂及血液流变学等,甲减组给予甲状腺素替代治疗至TSH、FT3、FT4恢复正常后复查上述的指标,并进行统计学处理。结果（1）与对照组比较,甲减组治疗前TSH、脂蛋白（a）[Lp（a）]、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B（ApoB）、全血黏度、血浆黏度、血沉（ESR）、血细胞刚性指数（IR）和血浆纤维蛋白原（Fg）均显著增高（IR P〈0.05余P均〈0.01）,FT3、FT4、高密度脂蛋白胆固醇（HDL-C）明显下降（均P〈0.05）,血细胞比容（Hct）和红细胞电泳时间（EPT）差异均无统计学意义（P〉0.05）;（2）与同组治疗前比较,治疗后的TSH、Lp（a）、TC、TG、LDL-C、ApoB、全血黏度、血浆黏度、ESR、IR和Fg明显下降（P均〈0.05）,FT3、FT4、HDL-C明显升高（P均〈0.05）;结论甲状腺素替代治疗甲减患者可有效改善其血脂代射,纠正血液流变学异常,可能预防或减少心脑血管并发症的发生。     

肥胖儿童血清瘦素水平与体格发育的关系

目的分析单纯性肥胖儿童血清瘦素、胰岛素、甲状腺素水平及其与体格发育的关系。方法对筛选出来的单纯性肥胖及体质量正常儿童各41例血清瘦素、空腹胰岛素、甲状腺素进行定量测定,并进行骨龄评定和体格测量。结果肥胖组血清瘦素、胰岛素、FT3含量均显著高于对照组;两组身高无显著差异;肥胖组坐高、足长、骨龄、血压等指标显著高于体质量正常儿童。结论肥胖儿童血清瘦素、胰岛素、FT3水平较高,瘦素可能对胰岛素、甲状腺素的分泌有正向调节作用;肥胖儿童体格发育较对照组早、快;可能与其血胰岛素及FT3水平较高有直接关系,而与瘦素水平较高可能是间接关系。