地方性克汀病人甲状腺功能的临床研究及对分型的探讨

THE STUDIES ON THYROID FUNCTION AND CLINICAL CLASSIFICATION OF ENDEMIC CRETINISM

对新疆阿克苏地区40名地方性克汀病患者及15名当地正常人进行了B超法甲状腺体积测量、血清激素(TSH、T_4、T_3)测定及皮肤组织粘液物质检查,以期了解该区地克病人的甲状腺功能水平。结果表明,40名克汀病人的平均TSH水平(30.85mU/L)明显高于当地正常人(3.25mU/L),按TSH不同水平将地克病人分为3组,则发现血清T_4、T_3水平随着TSH升高而逐渐下降、甲状腺体积逐渐减小、皮肤粘液物质检出率逐渐增加。结果提示新疆地区地克病人存在明显甲低,重度甲低组地克病人存在甲状腺萎缩,从而形成高TSH、低T_4、T_3的临床特点;但发生甲状腺萎缩的原因尚待进一步研究。本文结果还表明血清TSH水平在区分两种类型克汀病(神经型和粘肿型)中具有决定性作用。

40 endemic cretin patients and 15 local normal persons were examined by B ultrasonograph for thyroid volume measuring,serum TSH ,T4 ,T3 assay and dermal mucus detection in order to evaluate thyroid function status of endemic cretinism in Xinjiang. The results showed that the mean level of TSH in 40 cretins (30. 85mu/L)was obviously higher than that in local normal persons(3. 25mu/L),the serum T4,T3 levels and thyroid volume were decreased ,and the positive rate of dermal mucus test were increased with the TSH increase in three groups of cretin patients divided based on their TSH levels. These findings indicated that marked hypothyroidism existed in cretin patients of Xinjiang, and thyroid atrophy occurred in cretins with severe hypothyroidism, which was formulated the clinical feature of endemic cretinism with higher TSH and lower T3,T4,but the cause of thyroid atrophy need to be further studied. Also the results indicated the serum TSH level will play an important role in classification of two type cretinism (neurological and myxedematous).