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Establishment of normal reference value range of specific thyroid function in pregnant women with Beckman reagent in Chengdu area

ObjectiveTo establish a normal reference value range of specific thyroid function in pregnant women corresponding to Beckman reagent in Chengdu.MethodsWe randomly selected 120 non-pregnant women and 445 pregnant women who underwent routine examinations at the First Affiliated Hospital of Chengdu Medical College from November 2016 to June 2017; tested for free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in serum; used SPSS 24.0 to calculate the bilateral limit of each index (Section 2.5, 97. 5 Quot); established the normal range of Beckman reagent.ResultsThe reference ranges of FT3, FT4, and TSH in the first, second, and third trimester of pregnancy were 4.41–6.33, 4.17–6.12, and 3.86–6.39 pmol/L; 7.64–14.63, 6.62–13.69, and 6.62–12.51 pmol/L; 0.21–3.62, 0.16–4.35, and 0.89–4.88 mU/L; respectively. There was no significant difference in serum TSH between the first and second trimester (P>0.05), and neither between the first and second trimesters and the controls in serum FT3 (P>0.05). The differences in serum FT3, FT4, and TSH among the rest of trimesters, and between each trimester and the normal control group were statistically significant (P<0.05). There was a significant correlation between TSH and FT4 in the early and middle stages of pregnancy (r=–0.277, –0.392, P<0.01).ConclusionThe reference value of FT3, FT4, and TSH in pregnant women with Beckman reagent was significantly different from that in non-pregnant women.

Analysis of Paraoxonase 1 Activity in the Patients with Hyperhyroidism

目的:探讨甲状腺功能亢进症(甲亢)患者血浆对氧磷酯酶1(PON1)活性变化以及与其它氧化应激指标的关系。方法:分别测定50名对照组和78例甲亢组空腹血浆中游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、PON1活性、超氧化物歧化酶(SOD)、丙二醛(MAD)、氧化低密度脂蛋白(ox-LDL)及血脂含量,并进行相关性分析。 结果:甲亢患者血浆PON1活性(139 ±64)kU/L,ox-LDL(598.3±58.6)μg/L,MDA(15.11±3.26) μmol/L及SOD(80.2±25.3)NU/mL。对照组上述指标分别为:PON1(168 ±70)kU/L,ox-LDL (446.2±62.2) μg/L,MDA (10.02±3.00) μmol/L,SOD(92.9±26.9)NU/mL。血浆PON1和SOD活性显著低于对照组(Plt;0.01),ox-LDL和MDA水平显著高于对照组(Plt;0.01)。甲亢患者血浆PON1活性与SOD呈正相关(r=0. 381,Plt; 0.05),与ox-LDL、MDA呈负相关(r=-0. 411,r=-0. 445,Plt; 0.01)。 结论:甲亢患者血浆PON1活性显著降低,可能与氧化应激增强有关。

T3对心肌细胞肌浆网钙ATP酶基因表达的影响及其对心肌保护的基因调控作用

目的 研究不同甲状腺功能状态下，鼠缺血再灌注（Ischemia-reperfusion, I/R）心肌细胞肌浆网钙三磷酸腺苷酶(SRCa2+-ATPase)基因(SERCA2a)表达的变化，以及三碘甲状腺原氨酸(T3)对其变化的影响；探讨基因调控在心肌保护中的作用。方法 将实验大鼠随机分为甲状腺功能正常组（A组），甲状腺功能减退组（B组），两组又分别分为正常对照组、单纯灌注液组、T3灌注液组；利用离体心工作模型进行灌注；采用Northern-Blot方法测定各组心肌细胞SERCA2a mRNA的相对含量。结果 B组心肌细胞、I/R心肌细胞SERCA2a mRNA的表达均明显下降，而T3灌注液组其mRNA含量均显著提高，A组和B组中单纯灌注液组与T3灌注液组比较差别具有显著性意义(P＜0.01)，其变化状态与其心肌功能变化一致。结论 基因SERCA2a表达的显著下降是心肌I/R损伤的重要机制；T3是SERCA2a基因表达的促进剂，在I/R过程中可增强SERCA2a基因的表达，起到保护I/R心肌细胞、增强心肌功能的作用。

Clinical Features and Treatment Outcomes Analysis of Hyperthyroidism with Hepatic Injury

目的　总结甲状腺功能亢进症（甲亢）并肝损害的临床特征与治疗转归。 方法　回顾性分析2009年6月－2010年6月入院诊治的119例甲亢并肝损害患者（肝损害组）的临床特点与治疗转归资料，并与同期247例甲亢不伴有肝损害患者（无肝损害组）作比较。 结果　肝损害组占同期甲亢患者的30.4%，其中108例（90.8%）无明显肝损害的临床表现，以丙氨酸氨基转移酶和天门冬酸氨基转移酶升高为主，多为轻、中度升高；患者高代谢症候群、突眼、甲状腺肿大发生率及肿大程度明显高于无肝损害组，心率明显快于无肝损害组，血清游离三碘甲状腺原氨酸、游离甲状腺素及吸131I率明显高于无肝损害组，而体质量指数则明显低于无肝损害组（P＜0.05）。两组性别、年龄、病程、甲亢类型、甲状腺球蛋白抗体及甲状腺微粒体抗体滴度差异无统计学意义（P＞0.05）。肝损害组患者随访18个月以上，101例131I治疗患者随着甲亢控制，肝功能恢复正常，未见有再发肝损害；18例抗甲状腺药物治疗，其中10例随着甲亢控制，肝功能逐渐恢复正常；8例随着甲亢控制，肝功能逐渐恢复正常，但随着甲亢复发，再出现肝功能损害。 结论　肝损害是甲亢的常见并发症之一，其肝损害症状较轻，多数患者不典型，但并随甲亢病情较重。护肝治疗结合恰当的抗甲亢治疗预后良好。

The relationship between obesity and thyroid function

Obesity is closely related to thyroid function. The concentration of thyroid stimulating hormone (TSH) in obese patients is higher than that in the general population, and TSH will decrease accordingly after weight loss. Leptin is a bridge linking obesity and thyroid hormones, which can affect the release of TSH. There are many kinds of weight-reducing drugs that target the thyroid gland. Among them, thyroid hormone receptor-specific agonists may be potential drugs for future obesity treatment, but further studies are still needed.

Relationship between subclinical hyperthyroidism and the incidence of coronary heart disease: a meta-analysis

Objectives To assess the relationship between subclinical hyperthyroidism and the incidence of coronary heart disease (CHD). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, VIP, WanFang Data and CBM databases were searched for studies on the relationship between subclinical hyperthyroidism and the incidence of CHD from inception to October 2016. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software. Results In total, 14 cohort studies were included. The results of meta-analysis showed that subclinical hyperthyroidism was associated with the incidence of coronary heart disease (RR=1.19, 95%CI 1.01 to 1.40, P=0.04) and all-cause mortality (RR=1.36, 95%CI 1.11 to 1.67, P=0.003). Conclusions Subclinical hyperthyroidism is associated with an increased risk of CHD and all-cause mortality. Due to the limitation of quality and quantity of the studies, the above conclusions are required to be verified by large-scale and high quality research.

甲状腺功能减退合并抗利尿激素分泌失调综合征致低钠血症一例

Research progress on the relationship between hypothyroidism and atrial fibrillation

Atrial fibrillation is one of the most common arrhythmias, which can cause embolism, heart failure, cardiac arrest, and other cardiovascular deaths, causing a serious economic burden on patients. Scholars have begun to explore the relationship between atrial fibrillation and hypothyroidism, including clinical hypothyroidism, subclinical hypothyroidism, and threshold state of thyroid function, which means that thyroid stimulating hormone, free triiodothyronine, and free thyroxine are high or low in the normal range. This article reviews the occurrence and mechanism of hypothyroidism promoting atrial fibrillation, and aims to provide a basis for clinical intervention in patients with hypothyroidism to reduce the occurrence of atrial fibrillation.

Clinical practice of MDT in hypothyroidism complicated with postoperative gastroparesis syndrome after radical resection of right colon cancer

Objective To summarize clinical diagnosis and treatment of 1 case of hypothyroidism complicated with postoperative gastroparesis syndrome (PGS) after radical resection of right colon cancer. Method The multi-disciplinary (MDT) mechanism was used to discuss the MDT consultations of the departments of general surgery, endocrinology, nutrition, radiology, and pathology in a patient with hypothyroidism and right colon cancer after the radical resection. Results The MDT discussion concluded that the patient had a clear diagnosis of right colon cancer before the surgery, and the PGS occurred after the radical resection of right colon cancer. The patient had the hypothyroidism before the operation, and the occurrence of PGS might be related to the hypothyroidism. The experts of MDT recommended to treat with the thyroxine sodium and nutritional support treatment after the surgery. According to the results of the MDT discussion, the patient’s PGS was gradually cured and discharged smoothly after the thyroxine supplementation and nutritional support. Conclusions Hypothyroidism may be a risk factor for occurrence of PGS after radical resection of right colon cancer. MDT mechanism can provide an individualized optimal treatment for patients with hypothyroidism complicated with PGS after radical resection of right colon cancer and benefit these patients.

德阳地区健康体检人群中甲状腺功能检查的结果分析

目的 了解德阳地区健康体检人群中甲状腺功能检查（甲功）的异常情况，并分析异常类型及人群分布特点。 方法 收集医院体检中心2014年1月－9月体检人群的甲功检查报告，结合体检者个人信息，对甲功指标游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺素和抗体指标抗甲状腺球蛋白抗体（TgAb）、促甲状腺激素受体抗体（TRAb）、抗甲状腺过氧化物酶抗体（TPOAb）进行统计分析。 结果 在1 220例体检人群中，甲功指标异常201例（16.48%）；临床甲功异常[甲状腺功能亢进症（甲亢）+甲状腺功能减退（甲减）]检出率为1.14%，亚临床甲功指标异常（亚临床甲亢+亚临床甲减）检出率15.33%。甲功指标异常者中57.71%合并抗体指标阳性；1 019例甲功正常者中抗体指标异常183例（17.96%），其中抗体指标阳性率由高到低分别为TPOAb 9.62%、TgAb 8.24%、TRAb 4.12%。甲功指标异常在40～49岁年龄段检出率最高，达18.48%。 结论 德阳地区健康体检人群中甲功检查异常检出率较高，健康体检能及时发现亚临床甲功异常，尤其应该注重40～49岁人群的甲功检查。