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目的观察甲状腺素替代治疗对先天性甲状腺功能减低症(CH)患儿血清ghrelin水平的影响。方法研究对象为2007年10月-2008年3月在徐州医学院附属医院确诊并行治疗随访的CH患儿40例及健康体检儿童30例。分组:未治疗组包括甲状腺功能减低的CH患儿20例;治疗组包括新诊断或随访中经甲状腺素片治疗后甲状腺功能正常至少1个月的CH患儿20例;健康对照组年龄、性别相当的健康儿童30例。采用夹心法酶联免疫吸附试验测定3组儿童血清ghrelin水平,采用化学发光法测定三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、促甲状腺激素刺激激素(TSH)水平,同时计算每个样本的体质量指数(BMI)用于相关分析。结果 1.未治疗组ghrelin水平[(2.35±0.23)μg·L-1]虽高于治疗组[(2.16±0.25)μg·L-1]和健康对照组[(1.96±0.27)μg·L-1],但差异无统计学意义(P=0.102)。2.Ghrelin与年龄呈负相关(r=-0.325,P<0.05),但与性别、BMI、T3、T4、TSH无相关关系(Pa>0.05)。结论甲状腺激素对中枢或外周ghrelin的产生和分泌可能无调控作用。在不同生长发育时期,不同水平的ghrelin可能有不同的生理作用。
Objective To investigate the effect of thyroid hormone replacement therapy on ghrelin levels in children with congenital hypothyroidism (CH). Methods The object of study was 40 CH children and 30 healthy children who were followed up for diagnosis and treatment at the Affiliated Hospital of Xuzhou Medical College from October 2007 to March 2008. Group: untreated group including 20 cases of CH children with hypothyroidism; treatment group including 20 cases of CH children with thyroid function normal thyroid function at least 1 month after new diagnosis or follow-up; healthy control group age and gender 30 healthy children. Serum levels of ghrelin were measured by sandwich enzyme-linked immunosorbent assay (ELISA). The levels of triiodothyronine (T3), tetraiodothyronine (T4), thyrotropin-stimulating hormone (TSH) , While calculating the body mass index (BMI) for each sample for correlation analysis. The level of ghrelin in the untreated group [(2.35 ± 0.23) μg · L-1] was higher than that in the untreated group [(2.16 ± 0.25) μg · L-1] and [1.96 ± 0.27 μg · L-1 -1], but the difference was not statistically significant (P = 0.102). There was a negative correlation between Ghrelin and age (r = -0.325, P <0.05), but no correlation with gender, BMI, T3, T4 and TSH (Pa> 0.05). Conclusions Thyroid hormones may not regulate the production and secretion of ghrelin in central or peripheral area. At different stages of development, different levels of ghrelin may have different physiological effects.