目的 提高临床医生对甲状腺功能减退症（甲减）并发急性呼吸衰竭的认识，减少误诊，提高救治率。方法 对2002年11月－2011年6月收治的6例甲减并发急性呼吸衰竭患者予以有创机械通气及早期使用左旋甲状腺素治疗，使病症得以控制和治愈。 结果 患者使用有创机械通气治疗平均7 d，住院治疗14～43 d，平均（28.6 ±14.4）d， 5例治愈，1例死亡。 结论 甲减并发呼吸衰竭早期使用机械通气及甲状腺激素替代治疗可提高抢救成功率。
ObjectiveTo analyze and explore the thyroid defunctionalization method for preoperative preparation of hyperthyroidism patients in endoscopic thyroid surgery. MethodsThe clinical data of 45 cases of hyperthyroidism treated with endoscopic surgery in this hospital from June 2009 to June 2014 were analyzed retrospectively. These patients were divided into study group (n=20) and control group (n=25) according to the preoperative preparation method, the study group was prepared with thyroid defunctionalization method, the control group was prepared with antithyroid drugs and iodine. The intraoperative blood loss, conversion to open surgery, and postoperative complications were compared in these two groups. ResultsThe intraoperative blood loss and the operation time of the study group were significantly less than those of the control group﹝intraoperative blood loss: (120.32±50.26) mL versus (200.63±60.95) mL, P < 0.05; operation time: (120.43±40.56) min versus (180.76±50.92) min, P < 0.05﹞. There was no case of conversion to open surgery in the study group, there were three cases of conversion to open surgery in the control group. The incidence of postoperative complications of the study group was significantly lower than that of the control group﹝10% (2/20) versus 24% (6/25), P < 0.05﹞. ConclusionThyroid defunctionalization method is more suitable as compared with the traditional method for the preoperative preparation of hyperthyroidism in endoscopic thyroid surgery.
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(FT3)、游离甲状腺素(FT4)、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(Plt;0.01),ox-LDL和MDA水平显著高于对照组(Plt;0.01)。甲亢患者血浆PON1活性与SOD呈正相关(r=0. 381,Plt; 0.05),与ox-LDL、MDA呈负相关(r=-0. 411,r=-0. 445,Plt; 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。
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.
目的 探讨儿童甲状腺功能亢进症的治疗措施及临床效果。 方法 对入选的200例儿童甲状腺功能亢进症患儿给予甲巯咪唑0.5~1.0 mg/(kg•d)、盐酸普萘洛尔0.3 mg/(kg•d)治疗，2~4个月待患儿甲状腺功能基本恢复正常后，将患儿随机分为对照组(n=100)及研究组(n=100)。对照组只给予甲巯咪唑治疗，研究组则继续给予甲巯咪唑并联合左甲状腺素钠治疗。比较治疗前和治疗后6个月、1年及2年患儿甲状腺体积，FT4、FT3和TSH水平，观察治疗后2年不良反应发生情况。 结果 与对照组比较，治疗6个月后研究组甲状腺体积明显降低(Plt;0.05)，药物性甲状腺功能减退症发生率低(Plt;0.05)，不良反应少。 结论 两种治疗措施均能有效改善儿童甲状腺功能亢进症的高代谢症候群，使FT3、FT4及TSH水平恢复正常，甲状腺体积明显降低，但甲巯咪唑联合左甲状腺素钠治疗能更安全有效地控制甲状腺肿大及药物继发性甲状腺功能减退症，并能减少症状复发。
目的:通过对高胆红素血症新生儿换血前后血生化、甲状腺功能变化的检测,探讨其原因。方法:分别对17例高胆红素血症新生儿换血前后血常规、电解质、血糖及甲状腺功能等指标进行检测。结果:本组血清总胆红素和间接胆红素换血前、后有明显下降。换血后血电解质血钾降低,血钠、血钙升高,血糖暂时性升高,但在24 h内自行恢复至正常。可有贫血,白细胞及血小板明显下降,甲状腺功能变化没有显著性意义(Pgt;0.05),无明显并发症发生。结论:换血后可出现低钾、高钙、高钠、高血糖、低白细胞和血小板血症的发生,应预防感染、出血和电解质紊乱的发生。
ObjectiveTo investigate the correlation between abnormal thyroid function and benign or malignant breast tumors. MethodsThe contents of free iodine three original acid (FT3), three iodine original acid (T3), thyroxine (T4), free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin antibodies (Anti-TG), and antithyroid peroxidase antibody (Anti-TPO) were detected by chemiluminescence method in 563 patients with benign breast neoplasms, 87 patients with breast cancer, and 123 health examination population. ResultsT3 and T4 levels in patients with breast cancer were lower than those of normal control group and benign tumor group (P < 0.05). However, there were no significant difference in the levels of FT3, FT4, and TSH between the 3 groups (P > 0.05). The positive rates of Anti-TPO and Anti-TG were higher than those of benign group and normal group (P < 0.001). T3 and T4 levels in patients with breast cancer were not related to the expression of ER and PR, in Her-2 negative expression and lymph node metastasis were relatively low (P < 0.05). ConclusionThe decrease of contents of T3 and T4, and the positive expressions of Anti-TPO and Anti-TG may provide a basis for predicting the incidence of breast cancer.