宝石矽肺患者血清甲状腺激素水平测定及分析

目的探讨宝石矽肺患者的甲状腺功能状况，为矽肺的防治提供依据。方法采用放射免疫法分别对宝石矽肺患者66例（I期37例，Ⅱ期19例，Ⅲ期10例）和35名未接尘且体检健康的正常人（正常对照组，矽肺组均无甲状腺病史）进行血清中T3，T4及TSH水平。检测结果用两两比较的t检验进行统计学分析。结果患者血清中的T3及T4水平分别与对照组比较，差异都有显著性（P〈0．05，P〈0．01），而血清中TSH水平则相反（P〉0．05）；Ⅱ期矽肺与I期矽肺比较，两者差异无显著性（P〉0．05），而Ⅲ期矽肺患者与I期比较，两者差异有统计学意义（P〈0．01及P〈0．05）。另外，各期矽肺患者血清中的TSH水平则出现了随期数的增加而稍增加的趋势（P〈0．0172．P〈0．05），但Ⅱ、Ⅲ期矽肺分别与I期矽肺比较，其差异都无显著性（P〉0．05）。结论血清中甲状腺素水平的变化同样可以用于观察矽肺患者的甲状腺功能的状况。对于矽肺的辅助诊断及防治具有一定意义，但作为矽肺期别判断的参考指标，则有待以后进一步研究探讨。

Detection and analysis of serum thyroxine level in patients with gem silicosis

Objective To determine the level of thyroxine in serum of patients with gem silicosis and investigate the function of thyroid and provide evidence for prevention and treatment of the disease. Methods The serum levels of T3 , T4 and TSH in the observation group consisted of 66 patients（37 of them at phase I , 19 at phase Ⅱ and 10 at phase Ⅲ respetively） with gem silicosis and 35 healthy persons without exposed to gem dust in the control group were determined by radioimmune assay. The results were stitistically analysed. Results The serum levels of T3 and T4 in patients of the observation group were significantly lower than that of the control group , showing significantly stiatistical differences （ P 〈 0. 05, P 〈 0.01 ）. While the level of TSH in those of the observation group was higher than that of the controls without significant difference （ P 〉 0. 05 ）. The levels of T3 and T4 in the patients at phase II were not significantly different as compared to those at phase I, but there was significant difference in the levels of T3 and T4 in patients at phase Ⅲ as compared to those at phase I （P 〈0.01 ）. The levels of TSH were increased along with the development of phases of silicosis （ P 〈 0. 05, P 〈 0.05 ）. There no signifi- cant differences were observed in the levels of TSH in patients at phase II and III compared with that at phase I （ P 〉 0.05 ）. Conclusion The variations of level of T3 , T4 and TSH in the patients with silicosis reflect the status of function of thyroid glands in the patients and they are of significance in assistant diagnosis of silicosis. Further investigation be made in the use of the levels of T3 , T4 and TSH as reference indicators for differentiation of phasing of silicosis.