��״�ٹ��ܼ���֢ɸ��Ĺ�ʶ�����

??Abstract??Hypothyroidism is a common endocrine disease with a simple treatment and good prognosis.If this disease is left untreated??it can cause multiple organs abnormalities and affect fetal growth and development caused by hypothyroidism during pregnancy??Screening hypothyroidism has a great importance.Current??guidelines both in China and overseas for screening hypothyroidism have reached some consensus and show clearly who should undergo screening process and the diagnosis standard for different people has been established.This article express the consensus and differences of screening hypothyroidism in different populations who are non pregnant adults??pregnant women and newborns.     

术前抗甲状腺过氧化物酶抗体和抗甲状腺球蛋白抗体阳性与甲状腺结节良恶性的关系

回顾性调查1 552例甲状腺手术患者术前甲状腺相关抗体、手术记录、术后组织病理检查结果,评估术前甲状腺相关抗体抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(Tg Ab)与术后组织病理证实的甲状腺结节良恶性间的关系。术前TPOAb和(或)Tg Ab阳性可能是预测分化型甲状腺癌风险的一个指标,且与肿瘤恶性程度分期以及淋巴结转移有一定相关性。     

血清TSH水平与血脂异常的相关性研究

目的 探讨亚临床甲状腺功能减退(甲减)以及甲状腺功能正常的人群中TSH水平与血脂谱之间的关系.方法 2007年在沈阳市大东区进行糖尿病及甲状腺疾病的整群抽样调查,其中包括亚临床甲减110例和1 240名甲状腺功能正常者进入研究,研究对象既往无甲状腺病史,未服用影响甲状腺功能和调节血脂的药物.检查项目包括甲状腺功能、血脂、空腹血糖、胰岛素等.结果 (1)亚临床甲减患者高密度脂蛋白胆固醇(HDL-C)水平低于甲状腺功能正常组.(2)按照<中国成人血脂异常诊治指南>将人群分组,在超重的人群中(体重指数≥24.0 kg/m2),高低密度脂蛋白胆固醇(LDL-C)组的TSH水平明显升高[(3.07±0.27对2.41±0.11)mU/L,P=0.027],这种差异在超重女性组中更加明显.甲状腺功能正常且超重的人群中,TSH与总胆固醇呈正相关,且这种相关性不受稳态模型评估的胰岛素抵抗指数(HOMA-IR)的影响.(3)在女性中,TSH与甘油三酯呈正相关,与HDL-C呈负相关.在超重的女性组中,TSH与总胆固醇、LDL-C呈正相关,且经过年龄、性别、体重指数等因素的校正后相关性仍然存在.结论在甲状腺功能正常及亚临床甲状腺功能减退症人群中,TSH升高为血脂异常的危险因素,且独立于胰岛素抵抗.

Abstract：

Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.     

尿微量白蛋白排泄率与血清促甲状腺激素相关性研究

目的探讨尿微量白蛋白排泄率(ACR)与血清促甲状腺激素(TSH)的关系。方法 2007年10月对沈阳市大东区居民进行分层抽样调查共收集1523人,详细填写流行病学调查表,测量血压、身高、体重及腰围(WHR),采集血样测定TSH、甲状腺氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、空腹血糖(FPG)、糖负荷后30 min血糖(OGGT 30minPG)、2 h血糖(OGTT 2hPG)、空腹胰岛素浓度(FINS)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),采集空腹尿液检测尿微量白蛋白(MAU)及尿肌酐,计算尿微量白蛋白与尿肌酐比值。结果 MAU的发生率为11.8%,MAU的发生率随年龄的增长而增加(P<0.01)。MAU组较非MAU组的腰围、体重指数、收缩压、舒张压、心率、空腹血糖、糖负荷后30min血糖、糖负荷后2h血糖、TG、胰岛素抵抗指数均有明显升高(P<0.05);WHR、FINS、TC、HDL-C、LDL-C差异无统计学意义(P>0.05);TSH、亚临床甲减及亚临床甲亢的患病率差异亦无统计学意义(P>0.05);Logistic分析提示,高血压、高血糖是ACR的独立危险因素(OR值分别为1.868和1.469,P均<0.05)。结论 ACR与血清TSH未见相关性,高血糖、高血压是发生ACR的独立危险因素。     

术前血清促甲状腺素水平与甲状腺结节良恶性关系的研究

]调查了1 870例甲状腺手术患者的术前血清TSH、手术记录、术后组织病理报告等.发现分化型甲状腺癌患者的术前血清TSH明显高于良性甲状腺结节患者[(1.95±1.69对1.40±1.98)mIU/L,P＜0.01].在分化型甲状腺癌患者中,有淋巴结转移或肿瘤直径大于10 mm的患者较无淋巴结转移或肿瘤直径小于10 mm的患者术前血清TSH水平升高(均P＜0.01).提示术前血清TSH水平是预测分化型甲状腺癌风险的一个指标.     

维生素D对Graves病Th17/Treg细胞失衡的调节作用

目的 探讨维生素D对Graves病（Graves’ disease,GD）患者Th17/Treg失衡的调节作用。方法 收集2020年1月至12月复旦大学附属金山医院收治的30例GD患者和30例健康体检者。采用电化学发光免疫法测定2组人群25-羟维生素D水平,将GD患者外周血平均分为2份,根据是否予以维生素D干预分为GD未干预组和GD干预组。比较GD未干预组、GD干预组及对照组外周血中Th17、Treg细胞的占比及Th17/Treg比值。结果 GD患者血清25-羟维生素D[(20.55±6.69)ng/mL]明显低于对照组[（25.48±6.12）ng/mL,P=0.004]。GD未干预组、GD干预组及对照组外周血的Th17细胞占比分别为（0.299±0.191）%、（0.263±0.176）%、（0.054±0.017）%,两GD组外周血Th17细胞占比均高于对照组（P<0.001）,两GD组外周血Th17细胞水平差异无统计学意义。3组外周血Treg细胞占比分别为（0.029±0.013）%、（0.040±0.019）%、（0.037±0.017）%;两GD组外周血Treg细胞占...     

原发性痛风的诊治进展

原发性痛风是一种常见的代谢性疾病,随着饮食结构等生活方式的改变,发病率有逐年升高趋势。根据痛风的不同临床表现,可分为不同的疾病时期或阶段,而不同阶段痛风的治疗方法不同。痛风的治疗原则为控制急性痛风性关节炎、预防急性发作、纠正高尿酸血症、治疗慢性并发症。目前痛风的治疗仍存在一定的误区,需规范化。