Objectives To investigate the effects of new antiepileptic drugs [oxcarbazepine (OXC), levetiracetam (LEV), lamotrigine (LTG)] on thyroid hormones in male adults with epilepsy. Methods Thirty-eight newly diagnosed male adult patients with epilepsy were enrolled in the Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. The diagnosis was in line with the classification of epilepsy defined by the International League Against Epilepsy (ILAE, 1981). Only patients with generalized or secondary generalized epilepsy were recruited into the present study. Individual treatment with OXC, LEV, or LTG was randomly assigned to the 38 patients. Thyroid hormones was measured before treatment and 6 months after taking the medicine. Followed by an analysis of the comparison between the treated patients and healthy volunteers (healthy controls) as well as the changes and differences between the patients themselves before and after treatment. Results There was no significant difference in the thyroid hormone levels between male patients with epilepsy before taking the medicine and healthy controls (P>0.05). After 6 months, total thyroxine (TT4) and free thyroxine (FT4) in OXC group was significantly lower than the baseline (P<0.05). However, the thyroid hormone levels in the LEV group and LTG group showed no statistical difference before and after treatment (P>0.05). Conclusions OXC can reduce serum total thyroxine (TT4) and free thyroxine (FT4), which might be harmful to thyroid hormone of patients.
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.
ObjectiveTo set reference intervals of the levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies during three trimesters of pregnancy in Quanzhou city, Fujian province. MethodsA total of 490 pregnant women during 4-39 week pregnancy without presence of thyroid antibodies were enrolled in Quanzhou city, Fujian province. Levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid peroxidase antibodies (TPO-Ab) were detected through the electrochemistry immunoassay (ECL) method. In addition, a total of 51 healthy women without pregnancy were enrolled to set the reference intervals of levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies. ResultsThe median levels of TPO-Ab were in the reference intervals provided by the pharmaceutical factory. Levels of FT3 and FT4 gradually decreased from the first to the third trimester (P < 0.01), levels of serum TSH gradually increasd from the first to the third trimester (P < 0.01). Compared with those of pregnant women, levels of thyroid hormone in normal non-pregnant women were higher in the first trimester, lower in the second and the third trimesters (P < 0.01). During three trimesters, the reference intervals of FT3 in the three trimesters were (first: 3.75 to 7.23; second 3.31 to 4.9; and third: 3.16 to 4.48 pmol/L); the reference intervals of FT4 were (first: 12.85 to 25.3; second: 12.03 to 20.14; and third: 11.02 to 19.43 pmol/L); and the reference intervals of TSH were (first: 0.01 to 3.79; second: 1.09 to 4.19; and third: 1.08 to 5.95 mIU/L), respectively. ConclusionThrough this detection, we set the levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies during three trimesters of pregnancy in Quanzhou city.
ObjectiveTo investigate the association between serum thyroid hormone levels and prognosis for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) without thyroid disease, and explore the prognostic value of serum thyroid hormone levels for patients with AECOPD.MethodsThe clinical data of 239 hospitalized cases of AECOPD [149 males, 90 females, aged 42-92 (77.7±8.9) years] from January 2013 to November 2017 were retrospectively analyzed. Serum thyroid hormone levels including total tetraiodothyronin (TT4), total triiodothyronin (TT3), thyroid stimulating hormone (TSH), free tetraiodothyronin (FT4) and free triiodothyronin (FT3) were measured by chemiluminescence immunoassay. All patients were divided into a survival group and a death group according to the prognosis. Serum thyroid hormone levels were compared between two groups. Correlations of serum thyroid hormone levels with the occurrence of death in AECOPD patients were analyzed. The prognostic value of serum thyroid hormone levels for AECOPD patients was explored by receiveroperating characteristic (ROC) curve analysis. And the best cut-off value of serum thyroid hormone level in predicting the risk of death was calculated.ResultsSerum TT4, TT3, FT4 and FT3 levels in the survival group were significantly higher than those in the death group [TT4: (89.35±21.45) nmol/L vs. (76.84±21.33) nmol/L; TT3: (1.05±0.34) nmol/L vs. (0.72±0.19) nmol/L; FT4: (16.17±2.91) pmol/L vs. (14.45±2.85) pmol/L; FT3: (3.06±0.81) pmol/L vs. (2.24±0.72) pmol/L; all P<0.05]. The differences of serum TSH level between two groups were not statistically significant [0.98 (0.54-1.83)vs. 0.57 (0.31-1.84), P>0.05]. Spearman correlation analysis showed that serum TT4, TT3, FT4 and FT3 levels were significant correlated with the occurrence of death (r values were 0.226, 0.417, 0.220, 0.387, respectively, P<0.05). And there was no significant correlation between serum TSH level and the occurrence of death (P>0.05). ROC curve analysis was done between serum thyroid hormone levels (TT4, TT3, TSH, FT4 and FT3) and the occurrence of death in the AECOPD patients. The areas under ROC curve were 0.659, 0.793, 0.588, 0.655 and 0.772, respectively. Serum TT3 was the best indicator for predicting the occurrence of death. When serum TT3 level was 0.85nmol/L, the Youden index was the highest (0.486), with a sensitivity of 70.2%, and a specificity of 78.3%. It was the best cut-offl value of serum TT3 to predict the risk of death in AECOPD patients.ConculsionsSerum thyroid hormone levels are significant associated with the prognostic for AECOPD patients. There is certain value of serum thyroid hormone levels in prognostic evaluation of AECOPD patients.
Objective To investigate the therapeutic effects of thyroid hormone replacement on critically ill COPD patients with low serum thyroid hormone. Methods Sixty-seven critically ill patients with acute exacerbation of COPD ( AECOPD) , and complicated with respiratory and/ or heart failure and low serum thyroid hormone, admitted from July 2008 to June 2011, were recruited for the study. They were randomly divided into an intervention group ( n = 34) and a control group ( n = 33) . The control group received conventional treatment and the intervention group received conventional treatment plus additional thyroid hormone replacement therapy. Results Compared with the control group, the overall efficacy of the intervention group was not significantly different ( 88. 2% vs. 81. 8% , P gt; 0. 05) , while average effective time was significantly shorter [ ( 9. 6 ±2. 5) d vs. ( 12. 3 ±2. 8) d, P lt; 0. 05] . The post-treatment serum FT3 , FT4 , TT4 , and h-TSH levels were significantly higher in the intervention group than those in the control group, and significantly higher than baseline ( P lt;0. 05) . Conclusions For AECOPD patients complicated with respiratory and/or heart failure and low serum thyroid hormone, thyroid hormone supplement at low dosage will help to improve serumthyroid hormone level, and promote early recovery.
目的 研究高血压非瓣膜心房颤动患者甲状腺激素受体（TR）的活性差异，以探讨此类患者心房颤动发生发展的可能机制。 方法 2008年1月－2010年1月序贯收集103例高血压非瓣膜心房颤动患者的相关资料（48例阵发性心房颤动、55例持续性心房颤动），并收集50例单纯高血压患者。收集各组患者的相关人口学数据及检查结果，并采用放射性分析技术测定各组患者外周血淋巴细胞及淋巴细胞核TR的活性，主要包括平衡解离常数（Kd）及最大结合容量（MBC）。 结果 心房颤动患者淋巴细胞TR的Kd较单纯高血压患者小（越小表示与甲状腺激素的亲和力越高），且持续性心房颤动患者的Kd较阵发性心房颤动患者更小（0.77 ± 0.43、1.02 ± 0.41，P＜0.001）；心房颤动患者淋巴细胞TR的MBC较单纯高血压患者小(越小表示受体总量越少)，且持续性心房颤动患者TR的MBC较阵发性心房颤动患者更小（36.10 ± 12.40、65.22 ± 30.90，P＜0.001）。淋巴细胞核TR的Kd及MBC也存在类似情况。简单相关分析提示左房直径与淋巴细胞TR的Kd及MBC呈负相关，另外，调整相关指标后偏相关分析也提示左房直径与Kd及MBC呈负相关（Kd：r=?0.296，MBC：r=?0.448；P均＜0.01）；淋巴细胞核TR的Kd及MBC也存在类似情况。 结论 高血压非瓣膜心房颤动患者中，TR的总量减少，并且持续心房颤动组低于阵发心房颤动组；甲状腺激素与受体的亲和力在心房颤动患者中升高，且持续心房颤动组高于阵发心房颤动组。另外，还发现TR的Kd和MBC与左房直径均呈负相关。这些改变可能是高血压非瓣膜心房颤动患者心房颤动发生及维持的一种重要机制。
ObjectiveTo observe the transthyretin (TTR) gene mutation, protein and mRNA expression in patients with familial vitreous amyloidosis. MethodsSubjects were divided into three groups: (1) illness group: seven patients with familial vitreous amyloidosis. (2) No-illness group: 9 unaffected family members. (3) Control group: 9 healthy individuals in same area. Subjects' peripheral venous blood were collected and DNA were extracted, 4 exons of TTR gene were amplified by reverse transcription polymerase chain reaction(RT-PCR), the gene fragments were sequencing by the fluorescence labelling method. Serum TTR protein expression was detected by Western blot, and TTR mRNA in leukocyte was assayed by RT-PCR. Results4 exons of TTR gene of all samples were amplified, and DNA sequencing data showed that 7 patients and 3 subjects DNA from unaffected family members had mutated in the 3rd exon of 107th base, changing from G to C. Heterozygous mutation occurred in codon of the 83th amino acid in exon 3, namely, Gly83Arg, resulted in the change of GGC to CGC. The protein and mRNA expression of TTR was lower in illness group than no-illness group and control groups(P < 0.05). Compared with control group, TTR mRNA expression in unaffected family members groups was significant decreased(P < 0.05). ConclusionHeterozygous mutation occurred in codon of the 83th amino acid in exon 3, namely Gly83Arg, and suggested that Gly83Arg is connected with the change of TTR mRNA and protein expression.
Thirty patients with heperthyroidism were investigated for triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), thyromicrosome antibody (TMA), thyroglobulin antibody (TGA) and hydrocortisone before and after operation. The levels of serum T3, T4, TGA, TMA were markedly decreased after operation, and the level of hydrocortisone farther decreased from the preoperative low level. But only a little decrease in TSH level was found as compared with that before operation. The assay of these hormones and antibodies has very important clinical significance for judgement of the effect of operation and prevention of crisis of hyperthyroidism.