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Critical illness-implications of non-thyroidal illness syndrome and thyroxine therapy
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作者 Christos Savvidis Dimitra Ragia +5 位作者 Efthymia Kallistrou Eleni Kouroglou Vasiliki Tsiama Stella Proikaki Konstantinos Belis Ioannis Ilias 《World Journal of Critical Care Medicine》 2025年第3期50-60,共11页
Nonthyroidal illness syndrome(NTIS)is a common finding in critically ill patients,characterized by disruptions in the hypothalamus-pituitary-thyroid axis,resulting in altered levels of thyroxine(T4),triiodothyronine(T... Nonthyroidal illness syndrome(NTIS)is a common finding in critically ill patients,characterized by disruptions in the hypothalamus-pituitary-thyroid axis,resulting in altered levels of thyroxine(T4),triiodothyronine(T3),and reverse T3.This condition,often considered to be an adaptive response aimed at conserving energy,can become maladaptive in prolonged critical illness,contributing to poor outcomes in intensive care unit patients.The pathophysiology of NTIS involves cytokine-driven alterations in thyroid hormone(TH)metabolism,impaired hormone transport,and reduced receptor sensitivity,which-collectively-suppress thyroid function.Despite these insights,the therapeutic role of TH replacement in patients with NTIS remains uncertain.Low doses of levothyroxine and T3 have been trialed,particularly in patients with cardiovascular comorbidities,but clinical studies report conflicting results regarding their impact on mortality and overall patient outcomes.While some evidence suggests potential benefits of T3 administration in specific subgroups,such as patients with septic shock or severe coronavirus disease 2019,robust clinical trials have yet to conclusively demonstrate improved survival or recovery.The heterogeneity in NTIS presen-tation and treatment protocols,as well as the complex nature of TH regulation in critically ill patients,complicates efforts to establish clear guidelines for hormone therapy.Future research should prioritize individualized approaches,optimizing hormone dosing and timing,while aiming to elucidate the long-term effects of such interventions on critically ill patients to improve morbidity and mortality outcomes. 展开更多
关键词 Hypothalamus-pituitary-thyroid axis Critical illness Thyroid hormones thyroxine therapy Nonthyroidal illness syndrome Thyroid hormone therapy TRIIODOTHYRONINE L-thyroxinE
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Novel frameshift mutation causes early termination of the thyroxine-binding globulin protein and complete thyroxine-binding globulin deficiency in a Chinese family: A case report 被引量:1
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作者 Ping-Ping Dang Wei-Wei Xiao +5 位作者 Zhong-Yan Shan Yue Xi Ran-Ran Wang Xiao-Hui Yu Wei-Ping Teng Xiao-Chun Teng 《World Journal of Clinical Cases》 SCIE 2019年第22期3887-3894,共8页
BACKGROUND Thyroxine-binding globulin(TBG;the gene product of SERPINA7)is the main transporter of thyroid hormones in humans.Mutations in the TBG gene may lead to inherited TBG deficiency.There have been 28 reported m... BACKGROUND Thyroxine-binding globulin(TBG;the gene product of SERPINA7)is the main transporter of thyroid hormones in humans.Mutations in the TBG gene may lead to inherited TBG deficiency.There have been 28 reported mutations that associate with complete TBG deficiency(TBG-CD).Here we identified a novel frameshift mutation causing early termination of the TBG protein and TBG-CD in a Chinese family.CASE SUMMARY A 46-year-old Chinese man was referred to our hospital with normal free thyroxine,free triiodothyronine,thyrotropin,but lower total thyroxine and total triiodothyronine,and undetectable serum TBG,indicative of TBG-CD.Blood samples were obtained from the patient’s family members and thyroid function and serum TBG were evaluated.Genomic DNA from peripheral blood was sequenced to detect possible TBG mutation(s).Quantitative PCR high-resolution melting curve analysis was used to screen TBG-Poly(L283F)among 117 Chinese men.A novel mutation of TBG(p.Phe135Alafs*21),a 19-nucleotide insertion in exon 1,was identified,which resulted in a truncated TBG protein product and caused TBG-CD.The other mutation,identified in the proband’s father,is a known polymorphism,TBG-Poly(L283F).The frequency of the TBG-Poly allele among 117 unrelated Han Chinese men from northeast China was 21.37%.CONCLUSION A novel mutation in the TBG gene associated with the TBG-CD phenotype was identified in a Chinese family.Additionally,it was found that 21.37%of Chinese males had TBG-Poly(L283F). 展开更多
关键词 thyroxine-binding GLOBULIN COMPLETE thyroxine-binding GLOBULIN DEFICIENCY Partial thyroxine-binding GLOBULIN DEFICIENCY Gene polymorphism Case report
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Settlement and metamorphosis of Styela canopus Savigny larvae in response to some neurotransmitters and thyroxin 被引量:2
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作者 FENG Danqing HUANG Ying +2 位作者 KE Caihuan ZHOU Shiqiang LI Shaojing 《Acta Oceanologica Sinica》 SCIE CAS CSCD 2006年第3期90-97,共8页
The larvae of ascidian Styela canopus Savigny were treated with epinephrine, norepinephrine, L-DOPA, GABA and thyroxin to test the ability of these compounds to induce or inhibit larval settlement and metamorphosis. T... The larvae of ascidian Styela canopus Savigny were treated with epinephrine, norepinephrine, L-DOPA, GABA and thyroxin to test the ability of these compounds to induce or inhibit larval settlement and metamorphosis. The results showed that epinephrine, norepinephrine and L-DOPA at the concentration of 1 μmol/dm^3 induced larval settlement and metamorphosis in S. canopus, with short exposure ( 1 h) to 1 μmol/dm^3 of L-DOPA inducing rapid settlement. In contrast, GABA at the concentrations of 0.1 ~1130.0 μmol/dm^3 significantly inhibited the settlement and metamorphosis of S. canopus larvae. In addition, thyroxin at 1 -50 μg/dm^3 had no effect on larval settlement and metamorphosis in S. canopus. These results suggest the importance of neurotransmitters in the settlement and metamorphosis of S. canopus larvae. 展开更多
关键词 Styela canopus LARVAE settlement METAMORPHOSIS NEUROTRANSMITTER thyroxin
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Relationship between Free Thyroxine and Islet Beta-cell Function in Euthyroid Subjects 被引量:4
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作者 Qing LI Meng LU +9 位作者 Ning-jian WANG Yi CHEN Ying-chao CHEN Bing HAN Qin LI Fang-zhen XIA Bo-ren JIANG Hua-ling ZHAI Dong-ping LIN Ying-li LU 《Current Medical Science》 SCIE CAS 2020年第1期69-77,共9页
Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and n... Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and non-treated type 2 diabetes mellitus(T2DM)patients.A total of 5089 euthyroid participants(including 4601 general population and 488 non-treated T2DM patients)were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016.Anthropometric indices,biochemical parameters,and thyroid hormones were measured.Compared with general population,non-treated T2DM patients exhibited higher total thyroxine(TT4)and free thyroxine(FT4)levels but lower ratio of free triiodothyronine(T3):T4(P<0.01).HOMA-βhad prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age,body mass index(BMI)and smoking.When analyzed by quartiles of FT4 or free T3:T4,there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups.Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients,which was independent of age,BMI,smoking,hypertension and lipid profiles.FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects.Thyroid hormone even in reference range could play an important role in the function of pancreatic islets. 展开更多
关键词 free thyroxine free triiodothyronine islet beta-cell function euthyroid hormones DIABETES
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In vitro fluorescence displacement investigation of thyroxine transport disruption by bisphenol A 被引量:8
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作者 Jie Cao Liang-Hong Guo Bin Wan Yin Wei 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2011年第2期315-321,共7页
Bisphenol A (BPA) is a chemical with high production volume and wide applications in many industries. Although BPA is known as an endocrine disruptor, its toxic mechanisms have not been fully characterized. Due to i... Bisphenol A (BPA) is a chemical with high production volume and wide applications in many industries. Although BPA is known as an endocrine disruptor, its toxic mechanisms have not been fully characterized. Due to its structural similarity to thyroid hormones thyroxine (T4) and triiodothyronine (T3), one possible mechanism of BPA toxicity is disruption of hormone transport by competitive binding with the transport proteins. In this study, the binding interactions of BPA, T4, and T3 with three thyroid hormone transport proteins, human serum albumin (HSA), transthyretin (TTR), and thyroxine-binding globulin (TBG) were investigated by fluorescence measurement. Using two site-specific fluorescence probes dansylamide and dansyl-L-proline, the binding constants of BPA with HSA at drug site I and site II were determined as 2.90 × 10^4 and 3.14 × 10^4 L/mol, respectively. By monitoring the intrinsic fluorescence of tryptophan, a binding constant of 4.70 ×10^3 L/mol was obtained. Similarly, by employing 8-anilino-l-naphthalenesulfonic acid as fluorescence probe, the binding affinity of BPA with TTR and TBG was measured to be 3.10 × 10^5 and 5.90× 10^5 L/mol, respectively. In general, BPA showed lower binding affinity with the proteins than T3 did, and even lower affinity than T4. Using these binding constants, the amount of BPA which would bind to the transport proteins in human plasma was estimated. These results suggest that the concentrations of BPA commonly found in human plasma are probably not high enough to interfere with T4 transport. 展开更多
关键词 bisphenol A human serum albumin human transthyretin human thyroxine-binding globulin fluorescence displacement method
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Thyroxine treatment for elderly patients with heart failure and sick euthyroid syndrome 被引量:2
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作者 Yi ZHU Ling GONG +5 位作者 Kailei SHI Jin LI Zhaohui QIU Wenliang LU Yu ZHANG Jianying YANG 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2006年第4期242-245,共4页
Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome.Methods Forty-seven patients(33 males and 1... Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome.Methods Forty-seven patients(33 males and 14 females,mean age 85.9+4.6 years,ranging from 80 to 99 years)with chronic heart failure(NYHAⅡ-Ⅳ)and low triiodothyronine(T_(3))state were randomly allocated to the treatment group or control group.The treatment group patients received oral administration of levothyroxine sodium(Euthyrox)25-50mg/d in addition to conventional therapy of heart failure,whereas patients in control group were given conventional therapy only.Serum level of total T_(3)(TT_(3)),free T_(3)(FT_(3)),total thyroxine(TT_(4)),free thyroxine(FT_(4)),and thyroid-stimulating hormone(TSH)were determined.For both groups,left ventricular ejection fraction(LVEF)and stroke volume(SV)were assessed by two-dimensional echocardiography before and at 8 weeks after treatment.The changes of these parameters after the treatment were evaluated by adjusting heart rate in the two groups.Results The reduced serum T_(3) level in the treatment group was corrected after thyroid hormone therapy,and these patients had a significant improvement in cardiac function after treatment.By contrast,in the control group only changes of serum TT_(3) and TT_(4) levels and SV and LVEF after treatment were statistically significant.The heart rate-adjusted mean SV and LVEF in both groups were also increased,which was significantly greater in the treatment group than in the control group.Conclusion In the elderly patients with heart failure and sick euthyroid syndrome,addition of thyroxine at a low dosage to the conventional treatment could effectively improve the low T_(3) state and cardiac function independent of changes of heart rate. 展开更多
关键词 heart failure sick euthyroid syndrome ELDERLY thyroxinE
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Determination of Thyroxine with Capillary Electrophoretic Enzyme Immunoassay 被引量:1
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作者 Zhi Hui HE Wen Rui JIN 《Chinese Chemical Letters》 SCIE CAS CSCD 2002年第9期871-873,共3页
A Capillary electrophortic enzyme linked immunoassay with electrochemical detection (CE-EIA-ED) has been developed. The method can be used to determine thyroxine with a limit of 3.8×10-9 mol/L.
关键词 Capillary electrophortic enzyme immunoassay electrochemical detection thyroxine.
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Ameliorating Effects of Thyroxine and Atropine in Phosphamidon Intoxicated Chick Embryos
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作者 CHATTALI GHOSH AND J.N.MEDDA (Department of Zoology, Burdwan University, Burdwan 713104,West Bengal, INDIA)J.N.MEDDA (To whom all corespondences should be addressed.E-mail:zoojnm@burdwan.ernet.in.) 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 1999年第1期34-42,共9页
The effects of thyroxine and atropine in ameliorating phosphamidon intoxication in chick embryos was studied. Treatment of phosphamidon significantly enhanced the moriality and abnormalityrates, decreased the average ... The effects of thyroxine and atropine in ameliorating phosphamidon intoxication in chick embryos was studied. Treatment of phosphamidon significantly enhanced the moriality and abnormalityrates, decreased the average body weights, and cholinesterase activity in chick embryos. When thyroxine was administered to the phosphamidon intoxicated embryos, the above parameters changedsignificantly, indicating an ameliorating effect of thyroxine against phosphamidon intoxication in chick embryos. The combined thyroxine and atropine therapy did not further improve the ameliorating effect. Since in many respects chick embryo development parallels that of mammalian embryos,a short-term use of thyroxine as a protective agent against organophosphate toxicity might be useful 展开更多
关键词 ANIMALS ATROPINE Body Weight Central Nervous System Chick Embryo Cholinesterase Inhibitors CHOLINESTERASES Dose-Response Relationship Drug INSECTICIDES Kidney Liver Phosphamidon thyroxinE
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The effectiveness and safety of thyroxine replacement therapy for children with down syndrome and subclinical or congenital hypothyroidism—A systematic review
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作者 Ashwaq H. Al-Sabban Saleem Ahmed Jumana Y. Al-Aama 《Health》 2012年第8期452-456,共5页
Introduction: Down syndrome (DS) is the most common chromosomal abnormality causing mental handicap in humans. Children with DS have significant medical problems and developmental delay which are further impaired by h... Introduction: Down syndrome (DS) is the most common chromosomal abnormality causing mental handicap in humans. Children with DS have significant medical problems and developmental delay which are further impaired by hypothyroidism. Those clinical features are potentially improved by using thyroxine replacement therapy. Objectives: To examine the evidence of effectiveness (motor & mental development) and safety of thyroxine supplementation in the treatment of SH and CH in children with DS. Methods: Several medical data bases (MEDLINE, EMBASE, CINAHL, Cochrane, Clinical Trials Gov, Essential Evidence and Google) were searched until 20 October, 2011, for randomized control trials (RCTs) that had examined thyroxine’s effectiveness and safety in the treatment of SH or CH in children with DS. Results: There were two high quality RCTs that examined thyroxine in the treatment of CH in children with DS, and no RCTs were found to have examined the effectiveness of thyroxine for SH in children with DS. Conclusion: The RCT which met our inclusion criteria provides the reliable evidence in recommending thyroxine for the treatment of CH in children with DS which is similar to the guidelines for general population. The absence of RCTs examining the treatment of SH in Children with DS indicates the need to conduct such trials. 展开更多
关键词 Down SYNDROME CHILDREN SUBCLINICAL HYPOTHYROIDISM HYPOTHYROIDISM CONGENITAL HYPOTHYROIDISM thyroxinE
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The effect of maternal thyroxine injection on growth, survival and development of the digestive system of Nile tilapia, <i>Oreochromis niloticus</i>, larvae
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作者 Noha A. Khalil Hassan M. M. Khalaf Allah Mostafa A. Mousa 《Advances in Bioscience and Biotechnology》 2011年第5期320-329,共10页
The present study deals with the effect of exogenous treatment of O. niloticus females with L-thyroxine (T4) on the development of the digestive system during larval rearing, and its subsequent effect on larval growth... The present study deals with the effect of exogenous treatment of O. niloticus females with L-thyroxine (T4) on the development of the digestive system during larval rearing, and its subsequent effect on larval growth and survival. The development of the digestive tract and accessory glands was investigated histologically and histochemically in the developing O. niloticus larvae, from control and T4-treated spawners. During yolk-sac absorption, the digestive system of the fish underwent further differentiation and the rudimentary alimentary canal became segmented into four different histological regions: the buccopharynx, oesophagus, stomach and intestine. The injection of females O. niloticus with thyroxine (1 or 10 μg T4/g BW) greatly enhanced the development of the digestive tract and accessory glands of larvae as indicated by the quantitative and qualitative changes of the mucus composition from predominantly neutral to a mixture of neutral and acid mucosubstances, or acid mucosubstances occurred during the rearing period for the larvae produced from T4-treated females. This may be due to the direct effect of exogenous thyroxine, which might have been transferred from maternal circulation into the oocytes and larvae, on the synthesis of proteins, which increased with larval development. Thus, thyroxine directly or indirectly improved O. niloticus larval growth, since a marked increase in both, length and weight of larvae occurred during the experimental period. In addition, larvae from treated females also gave a significantly higher survival rate than that of control. It could be concluded that exogenous T4 in maternal circulation might have been transferred into oocytes and larvae. The transferred thyroid hormone appears to play some role in the early development of larvae and may confer a distinct advantage for the growth of the offspring of the Nile tilapia, O. niloticus. 展开更多
关键词 Fish LARVAE O. NILOTICUS thyroxinE GROWTH Digestive System
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THE EFFECTS OF RECOMBINANT EEL GROWTH HORMONE,METHYLTESTOSTERONE AND L-THYROXINE ON THE GROWTH OF REDSEABREAM,PAGROSOMUSMAJOR
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作者 徐斌 葛国昌 苗宏志 《Chinese Journal of Oceanology and Limnology》 SCIE CAS CSCD 1995年第1期86-96,共11页
The effects of recombinant eel growth hormone (reGH).methyltestosterone (MT)and L-thyroxine (T4)on the growth of red sea bream. Pagrosomus major.were investigated.Administration of reGH to fry by immersion at 2 mg 1 f... The effects of recombinant eel growth hormone (reGH).methyltestosterone (MT)and L-thyroxine (T4)on the growth of red sea bream. Pagrosomus major.were investigated.Administration of reGH to fry by immersion at 2 mg 1 for 2 hevery 5 dsys resulted in significant increase in both weight and length.but the condition factor (CF) diminished relative to that of similarly treated controls over the 37day treatment period.Immersion in 0.1 mg:1 T4 also resulted in significant increase in both weight and length and higher survival rate of test fry compared to the controls. Immersion in MT had less effect on growth and high-dose resulted in high mortality.In the second study.injection of 2 μg reGH(gwk)caused a significant increase in the specific growth rate (SGR) of test red sea bream fingerlings relative to that of the controls during the 4-week treatment period and maintained the increasing trend over the post-treatment period (weeks 4-6).Injection of MT at a dosage of 1μg (gwk) resulted in a significant 展开更多
关键词 GROWTH hormone. methyltestosterone. L-thyroxine. growth. red sea BREAM
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Hormonal (Thyroxin, Cortisol) and Immunological (Leucocytes) Responses to Cistern Size and Heat Stress in Tunisia
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作者 Rim Ben Younes Moez Ayadi +3 位作者 Taha Najar Margherita Caccamo Iris Schadt Moncef Ben M'Rad 《Journal of Life Sciences》 2011年第5期332-338,共7页
This study was designed to determine the effects of heat stress on plasma leucocytes, Thyroxin (T4) and cortisol concentrations in dairy cows with small and large cistern under hot climate. This experiment was carri... This study was designed to determine the effects of heat stress on plasma leucocytes, Thyroxin (T4) and cortisol concentrations in dairy cows with small and large cistern under hot climate. This experiment was carried out in 2006, in North Tunisia, using a randomized block design per udder cistern size, using 60 Holstein cows. Cows were classified according to udder cistern size by ultrasonography as large-cisterned (44 ±13 cm2; LC) and small-cisterned (21 ± 8 cm2; SC). The experiment was carried out in two different periods: spring (Apr. 5 (D1)) and summer (July 19 (D2), Aug. 19 (D3) and Sept. 19 (D4)). On each test day, temperature and relative humidity data were registered hourly and cows' blood was sampled from the jugular vein to determine serum concentrates of cortisol and T4. Leucocytes (lyrnphocytes, eosinophils, neutrophils and monocytes) were counted differentially, and percentages of lymphocytes relative to total counted cells were calculated. Mean temperature-humidity index (THI) values were 62 ±2, 79 ±2, 84 ±2, and 77 ±1 in DI, D2, D3, and D4, respectively. Lymphocyte incidence relative to total cell counts and T4 concentrations were affected by test day (P 〈 0.001). Lymphocytes (%) were significantly less in hotter months. During summer, T4 concentration at D2 (87.4 nmol/L) was higher relative to concentrations at D3 (42.8 nmol/L) and D4 (53.5 nmol/L). T4 concentrations were higher (P 〈 0.01) in SC cows (67.7 ±0.1 nmol/L) compared to LC cows (52.7 ±0.1 nmol/L). Cortisol concentration was effected neither by test day nor by cistern size. However, the decrease of lymphocyte concentration during summer compared to spring could be considered as an evidence of the suppression of cows' immune system under heat stress. 展开更多
关键词 Heat stress cistern size CORTISOL thyroxin lymphocytes.
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Sequential defunctionalization followed by thyroxine supple-mentation as preoperative preparation of hyperthyroid patients undergoing thyroidectomy 被引量:2
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作者 ZHU Jing-qiang LI Zhi-hui +7 位作者 GONG Ri-xiang WEI Tao ZHANG Heng ZHANG Wen-yan YANG Xiao-yan LUO Yan-li GONG Shu WU Xiao-ying 《Chinese Medical Journal》 SCIE CAS CSCD 2008年第20期2010-2015,共6页
Background Preparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of t... Background Preparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of thyroid function. We therefore used large doses of antithyroid drugs to completely inhibit the synthesis of thyroxine and render the thyroid gland defunctionalized. We then administered physiologic doses of thyroxine to inhibit thyroid-stimulating hormone secretion. We have named this treatment “sequential thyroid defunctionalization followed by thyroxine supplementation.” Methods Four hundred and seventy-one hyperthyroid patients seen at our hospital were divided into experimental and control groups. The control group was treated preoperatively with antithyroid drugs and iodine preparation. The experimental group was further divided into four subgroups and treated with “sequential thyroid defunctionalization followed by thyroxine supplementation”. Each of the four subgroups received different doses of antithyroid drugs and thyroxine for differing time periods. Thyroid function was assessed at each stage of treatment, as were operative blood loss volumes and postoperative complications. Results Compared to the control group, the four experimental groups showed less thyroid congestion and surface varices at surgery. Patients in subgroup A also had thyroid glands that were almost histologically normal. The mean operative blood loss volume of the experimental group was less than that of the control group ((326±163) ml in the control group; (196±57) ml in subgroup A; (230±71) ml in subgroup B; (240±80) ml in subgroup C; and (312±97) ml in subgroup D). The postoperative complication rate of the experimental group was 8.64% (21/243) whereas that of the control group was 17.54% (40/228). Conclusions Sequential thyroid defunctionalization followed by thyroxine supplementation is effective in reducing the bleeding volume and postoperative complication rate in selected hyperthyroid patients undergoing thyroidectomy. 展开更多
关键词 HYPERTHYROIDISM preoperative procedures thyroxinE
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NLR、FT_(3)联合FT_(3)/FT_(4)对重症病毒性脑炎患儿脑功能预后不良的预测价值研究
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作者 刘晓燕 陆丽娟 +1 位作者 顾敏 陈玲 《实用心脑肺血管病杂志》 2026年第1期39-43,50,共6页
目的探讨中性粒细胞与淋巴细胞比值(NLR)、游离三碘甲状腺原氨酸(FT_(3))联合FT_(3)/游离甲状腺素(FT_(4))对重症病毒性脑炎患儿脑功能预后不良的预测价值。方法回顾性选取2021年2月—2025年1月常州市儿童医院收治的169例重症病毒性脑... 目的探讨中性粒细胞与淋巴细胞比值(NLR)、游离三碘甲状腺原氨酸(FT_(3))联合FT_(3)/游离甲状腺素(FT_(4))对重症病毒性脑炎患儿脑功能预后不良的预测价值。方法回顾性选取2021年2月—2025年1月常州市儿童医院收治的169例重症病毒性脑炎患儿为研究对象。根据重症病毒性脑炎患儿脑功能预后将其分为预后不良组〔小儿大脑及整体表现分类量表(PCOPCS)评分3~6分,n=80〕与预后良好组(PCOPCS评分1~2分,n=89)。重症病毒性脑炎患儿脑功能预后的影响因素分析采用多因素Logistic回归分析;NLR、FT_(3)、FT_(3)/FT_(4)及三者联合对重症病毒性脑炎患儿脑功能预后不良的预测价值采用ROC曲线分析。结果预后不良组合并应激性高血糖者占比、白细胞计数、C反应蛋白(CRP)、NLR、脑脊液蛋白高于预后良好组,FT_(3)、FT_(3)/FT_(4)、脑脊液白细胞计数、格拉斯哥昏迷量表(GCS)评分、振幅整合脑电图(aEEG)评分低于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,合并应激性高血糖〔OR=12.332,95%CI(3.186~47.734)〕、NLR〔OR=12.876,95%CI(3.361~49.330)〕、FT_(3)〔OR=0.182,95%CI(0.107~0.309)〕、FT_(3)/FT_(4)〔OR=0.736,95%CI(0.667~0.812)〕、GCS评分〔OR=0.470,95%CI(0.366~0.603)〕、aEEG评分〔OR=0.328,95%CI(0.234~0.461)〕为重症病毒性脑炎患儿脑功能预后的独立影响因素(P<0.05)。ROC曲线分析结果显示,NLR、FT_(3)、FT_(3)/FT_(4)及三者联合预测重症病毒性脑炎患儿脑功能预后不良的AUC分别为0.718、0.841、0.802、0.906;三者联合预测重症病毒性脑炎患儿脑功能预后不良的AUC大于NLR、FT_(3)、FT_(3)/FT_(4)单独预测重症病毒性脑炎患儿脑功能预后不良的AUC(Z=4.132,P<0.001;Z=2.987,P=0.003;Z=2.154,P=0.031)。结论NLR、FT_(3)、FT_(3)/FT_(4)是重症病毒性脑炎患儿脑功能预后的独立影响因素,三者联合对重症病毒性脑炎患儿脑功能预后不良具有较高的预测价值。 展开更多
关键词 脑炎 病毒性 中性粒细胞与淋巴细胞比值 游离三碘甲状腺原氨酸 游离甲状腺素 预后 预测价值
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孕早期甲状腺功能正常妇女甲状腺自身免疫与妊娠期糖尿病的相关性研究
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作者 赵越 阮祥燕 +4 位作者 邹丽颖 马郡 王月姣 田玄玄 金婧 《首都医科大学学报》 北大核心 2025年第4期626-631,共6页
目的探讨妊娠早期甲状腺功能正常女性甲状腺自身免疫(thyroid autoimmunity,TAI)与妊娠期糖尿病(gestational diabetes mellitus,GDM)之间的相关性。方法选取2023年6月至2024年6月于首都医科大学附属北京妇产医院产科门诊规律产检、孕... 目的探讨妊娠早期甲状腺功能正常女性甲状腺自身免疫(thyroid autoimmunity,TAI)与妊娠期糖尿病(gestational diabetes mellitus,GDM)之间的相关性。方法选取2023年6月至2024年6月于首都医科大学附属北京妇产医院产科门诊规律产检、孕前未确诊甲状腺疾病、孕早期甲状腺功能正常产妇508例,收集患者基线特征、孕早期(孕6~10周)促甲状腺激素(thyrotropin,TSH)、游离甲状腺素(free thyroxine,fT4)、甲状腺过氧化物酶抗体(thyroid peroxidase antibodies,TPOAb)浓度,孕24~28周75 g葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果,根据OGTT结果分为GDM组(n=169)和非GDM组(n=339),对两组TAI阳性发生率、一般情况、甲状腺功能指标等情况进行分析比较。多因素Logistic回归分析GDM的发生因素。结果GDM组年龄、体质量指数(body mass index,BMI)、孕前肥胖者均显著高于非GDM组,差异有统计学意义(P<0.001)。GDM组年龄超过30岁孕妇比例显著高于非GDM组(59.17%vs 6.79%,χ^(2)=168.667,P<0.001)。孕前肥胖(BMI≥28 kg/m^(2))产妇在GDM组中占比为24.26%,显著高于非GDM组的8.26%(χ^(2)=24.599,P<0.001)。GDM组中TAI发生率54.44%,非GDM组TAI的发生率为15.93%,两组间差异有统计学意义(χ^(2)=81.659,P<0.001)。Logistic回归分析结果显示年龄超过30岁及孕前肥胖使TAI产妇GDM发生风险增加6.08倍(OR=6.08,95%CI:3.61~10.25,P<0.001)。结论早期甲功正常女性中,随诊年龄增大(尤其超过30岁)、孕前BMI增高(尤其肥胖者)、孕前TAI者,孕期发生GDM的风险显著增加,未来旨在探究甲状腺功能正常的TAI女性发生GDM的预防策略,以期改善不良妊娠结局。 展开更多
关键词 甲状腺自身免疫 甲状腺过氧化物酶抗体 妊娠期糖尿病 促甲状腺激素 游离甲状腺素 孕早期
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鲁南地区不同孕期甲状腺功能指标参考区间的建立
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作者 刘婷 高晓梅 +2 位作者 姜家利 孙阳 刘爱香 《临床医学研究与实践》 2025年第12期1-4,共4页
目的建立鲁南地区妊娠妇女不同孕期甲状腺功能指标参考区间,为本地区妊娠妇女甲状腺疾病的准确诊断提供参考依据。方法选取399名妊娠妇女作为妊娠组,根据不同孕期将其分为妊娠早期(T1组,133名)、妊娠中期(T2组,133名)、妊娠晚期(T3组,13... 目的建立鲁南地区妊娠妇女不同孕期甲状腺功能指标参考区间,为本地区妊娠妇女甲状腺疾病的准确诊断提供参考依据。方法选取399名妊娠妇女作为妊娠组,根据不同孕期将其分为妊娠早期(T1组,133名)、妊娠中期(T2组,133名)、妊娠晚期(T3组,133名);另选取同期健康非妊娠妇女200名作为对照组(T0组)。检测所有研究对象的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)、甲状腺过氧化物酶抗体(TPO-Ab)及甲状腺球蛋白抗体(Tg-Ab)水平。比较妊娠妇女不同孕期甲状腺功能指标水平;建立妊娠妇女不同孕期甲状腺功能指标参考区间;比较不同参考区间诊断妊娠甲状腺功能异常的检出率。结果T1组、T2组、T3组及T0组的FT_(3)、FT_(4)、TSH水平比较,差异具有统计学意义(P<0.05)。妊娠妇女中,T1组的FT_(3)、FT_(4)水平最高,TSH水平最低,随着孕周增加,FT_(3)、FT_(4)水平逐渐降低,TSH水平逐渐升高。T1组、T2组、T3组的FT_(3)参考区间分别为2.50~3.90 pg/mL、2.17~3.54 pg/mL、2.24~3.27 pg/mL,FT_(4)参考区间分别为0.91~1.71 ng/dL、0.86~1.38 ng/dL、0.75~1.26 ng/dL,TSH参考区间分别为0.06~5.12μIU/mL、0.39~4.32μIU/mL、0.43~4.13μIU/mL。根据指南参考区间对妊娠期甲状腺功能异常的检出率低于本地区建立的参考区间(P<0.05)。结论建立鲁南地区不同孕期甲状腺功能指标参考区间,不仅能够揭示妊娠妇女不同孕期甲状腺激素变化规律,还可提升甲状腺疾病检出率。 展开更多
关键词 鲁南地区 不同孕期 游离三碘甲状腺原氨酸 游离甲状腺素 促甲状腺激素
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男性酒精依赖患者血清Hcy、hs-CRP及甲状腺素水平与抑郁风险的关系
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作者 郭瑞娟 刘利娜 王丹 《国际精神病学杂志》 2025年第5期1502-1505,1540,共5页
目的研究男性酒精依赖患者血清同型半胱氨酸(Homocystine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)及甲状腺素水平与抑郁风险的关系。方法观察2022年1月~2024年1月于濮阳市人民医院和濮阳市精神卫生中心就诊的... 目的研究男性酒精依赖患者血清同型半胱氨酸(Homocystine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)及甲状腺素水平与抑郁风险的关系。方法观察2022年1月~2024年1月于濮阳市人民医院和濮阳市精神卫生中心就诊的男性酒精依赖患者100例,采用汉密尔顿抑郁量表(Hamilton Depression Rating Scale,HAMD)分为抑郁组62例(HAMD≥8分)与非抑郁组38例(HAMD<8分)。收集患者相关基本资料,通过ROC及多因素Logistic回归分析男性酒精依赖患者抑郁发生的影响因素。结果抑郁组Hcy、hs-CRP、促甲状腺素(Thyroid Stimulating Hormone,TSH)高于非抑郁组,游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)低于非抑郁组(P<0.05);经多因素Logistic回归分析证实,Hcy>19.916μmol/L、hs-CRP>3.704 mg/L、TSH>2.370μIU/mL、FT4<1.285 ng/dL、FT3<2.947 pg/mL均是男性酒精依赖患者发生抑郁的危险因素(P<0.05);经ROC分析表明,Hcy、hs-CRP、TSH、FT4、FT3可用于预测患者抑郁的发生,曲线下面积分别为0.771、0.875、0.808、0.745、0.866,且联合检测预测患者抑郁发生的效能显著高于单独检测(P<0.05)。结论Hcy、hs-CRP、TSH、FT4、FT3均是男性酒精依赖患者发生抑郁的危险因素,可用于预测患者抑郁的发生风险。 展开更多
关键词 男性 酒精依赖 同型半胱氨酸 超敏C反应蛋白 甲状腺素
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血清p53、VEGF、TgAb、TPOAb联合超声造影定量参数对甲状腺结节良恶性的诊断价值
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作者 瓦增成 贾得艳 杜婷 《医学临床研究》 2025年第5期788-790,794,共4页
【目的】探讨血清p53、血管内皮生长因子(VEGF)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)联合超声造影定量参数对甲状腺结节良恶性的诊断价值。【方法】选取2020年4月至2023年4月青海红十字医院收治的100例甲状腺结节病... 【目的】探讨血清p53、血管内皮生长因子(VEGF)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)联合超声造影定量参数对甲状腺结节良恶性的诊断价值。【方法】选取2020年4月至2023年4月青海红十字医院收治的100例甲状腺结节病变患者,根据病理检查结果分为良性组(n=71)与恶性组(n=29),比较两组血清p53、VEGF、TgAb、TPOAb水平及超声造影参数[达峰时间(TTP)、峰值强度(Imax)],采用受试者工作特征(ROC)曲线评估血清p53、VEGF、TgAb、TPOAb联合超声造影参数对甲状腺结节良恶性的诊断价值,并采用Pearson分析血清p53、VEGF、TgAb、TPOAb与甲状腺恶性结节的相关性。【结果】良性组p53、VEGF、TgAb、TPOAb水平低于恶性组,TTP长于恶性组,Imax高于恶性组。ROC曲线分析结果显示:血清p53、VEGF、TgAb、TPOAb联合超声造影参数诊断甲状腺结节良恶性的灵敏度为96.6%,特异度为97.2%,ROC曲线下面积(AUC)为0.988,联合检测诊断价值高于单项指标检测。相关性分析结果显示:血清p53、VEGF、TgAb、TPOAb与甲状腺恶性结节呈正相关(P<0.05)。【结论】血清p53、VEGF、TgAb、TPOAb联合超声造影参数可有效提高诊断甲状腺结节良恶性的准确性,具有较高的诊断灵敏度和特异度。 展开更多
关键词 甲状腺结节 血管内皮生长因子A 甲状腺素结合球蛋白 促甲状腺素
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Correlation between diabetic peripheral neuropathy and thyroid hormone sensitivity in elderly patients with type 2 diabetes mellitus
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作者 Si-Jia Fei Jing-Yi Luo +2 位作者 Wei-Hao Wang Li-Xin Guo Qi Pan 《World Journal of Diabetes》 2025年第2期71-80,共10页
BACKGROUND Diabetic peripheral neuropathy(DPN)is a common complication of type 2 diabetes mellitus(T2DM),significantly affecting patients’quality of life and imposing a substantial economic burden.Recent studies have... BACKGROUND Diabetic peripheral neuropathy(DPN)is a common complication of type 2 diabetes mellitus(T2DM),significantly affecting patients’quality of life and imposing a substantial economic burden.Recent studies have highlighted the role of thyroid hormones in diabetes complications,particularly in elderly patients with T2DM.However,the relationship between thyroid hormone sensitivity and DPN remains unclear.AIM To investigate the correlation between thyroid hormone sensitivity and DPN in elderly patients with T2DM.METHODS In a cohort of 256 elderly patients with T2DM,propensity score matching was used to balance age,sex,and diabetes duration.Clinical data were collected to calculate thyroid hormone sensitivity and analyze its correlation with DPN.A random forest model was used to evaluate the diagnostic value of free triiodothyronine/free thyroxine(FT_(3)/FT_(4))for DPN.RESULTS Patients with DPN had a lower FT_(3)/FT_(4) ratio[(0.302±0.053)vs(0.316±0.049),P=0.040].Quartile stratification showed decreasing DPN prevalence with higher FT_(3)/FT_(4) ratios.Spearman’s correlation analysis showed that a lower FT_(3)/FT_(4) ratio was associated with higher glycated hemoglobin,fasting blood glucose,reduced nerve conduction velocity,and electrical skin conductance.Logistic regression indicated a positive relationship between the median FT_(3)/FT_(4) ratio and bilateral foot electrochemical skin conductance[odds ratio(OR):1.019;95%CI:1.005-1.034;P=0.007]and sural nerve sensory amplitude(OR:1.310;95%CI:1.008-1.703;P=0.043).Receiver operating characteristic analysis using a random forest model showed that incorporating FT_(3)/FT_(4) improved predictive performance for DPN,with an area under the curve of 0.74,sensitivity of 0.79,specificity of 0.64,and accuracy of 0.77.CONCLUSION In elderly patients with T2DM with euthyroidism,a lower FT_(3)/FT_(4) ratio is correlated with increased DPN incidence,affecting both large and small nerve fibers.FT_(3)/FT_(4) is an effective predictor of DPN. 展开更多
关键词 Diabetic peripheral neuropathy Thyroid hormone sensitivity Type 2 diabetes mellitus ELDERLY Free triiodothyronine/free thyroxine ratio
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甲状腺结合球蛋白缺乏症3个家系报告
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作者 李苗苗 潘桂梅 +7 位作者 刘磊 陈琼 李杨世玉 张子夏 王曦 杜萌萌 卫海燕 陈永兴 《临床儿科杂志》 北大核心 2025年第8期598-603,共6页
目的 旨在探讨甲状腺结合球蛋白(TBG)缺乏症的临床特征和遗传学特点,提升临床诊断准确性,避免误诊及过度治疗。方法 对来自3个不同家系的成员进行SERPINA7基因测序,探究其遗传基础。结果 通过全外显子组测序检测出3个家系的变异均发生... 目的 旨在探讨甲状腺结合球蛋白(TBG)缺乏症的临床特征和遗传学特点,提升临床诊断准确性,避免误诊及过度治疗。方法 对来自3个不同家系的成员进行SERPINA7基因测序,探究其遗传基础。结果 通过全外显子组测序检测出3个家系的变异均发生在外显子,分别为c.712A>G(p.M238V)、c.1114delC(p.L372Ffs*23)、c.383-401dup(p.F135Afs*21),其中家系1、家系3的变异属首次报道。结论 TBG缺乏症无需特殊治疗,正确的诊断与全面的疾病教育是该病管理的关键。本研究发现了2个新的SERPINA7基因变异,拓展了该基因的变异谱。 展开更多
关键词 TBG缺乏症 SERPINA7 基因检测
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