先天性甲状腺功能减低症患儿血清Leptin浓度及其与PTA关系的研究  

Investigation of serum leptin and its relation to pituitary thyroid axis in infants with congenital hypothyroidism.

作　　者：张立琴[1] 傅平[1] 李文杰[1] 王培林[2] 宋扬[1] 李伟[1] 

机构地区：[1]青岛市妇女儿童医疗保健中心,山东青岛266011 [2]青岛大学医学院遗传学教研室,山东青岛266022

出　　处：《中国儿童保健杂志》2005年第6期481-483,共3页Chinese Journal of Child Health Care

基　　金：青岛市卫生局科技发展项目(2004-WSJD041)

摘　　要：【目的】探讨先天性甲状腺功能减低症(congenital hypothyroidism,CH,简称甲低)患儿治疗前、后血清瘦素(leptin)浓度的变化以及与垂体-甲状腺轴(pituitary thyroid axis,PTA)的关系,为CH患儿的监测、治疗提供新的理论依据。【方法】分别测定23例CH患儿治疗前、后及性别、年龄、体质指数(body mass index,BMI)与之相匹配的46例健康对照组婴儿血清Leptin浓度(采用RIA法)及游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid stimulating hormone,TSH)浓度(采用ECLIA法)。所有数据输入SPSS 10.0统计软件包进行分析。【结果】①CH患儿治疗前、后分别与其对照组比较,血清FT4有明显差异,Leptin浓度无差异。②甲低组Leptin浓度与FT4浓度呈正相关,与TSH呈负相关;而正常对照组Leptin浓度与FT4浓度呈负相关,与TSH无相关性。③甲低组治疗后Leptin及FT4浓度增高幅度大于对照组,二者比较差异均有显著性,而BMI变化差异无显著性。【结论】①FT4、TSH对CH患儿Leptin的代谢有调节作用,这种调节作用可能不依赖于BMI;②检测leptin浓度有可能成为指导临床治疗CH的辅助检查手段。[Objective] To study the changes of serum leptin concentration in infants with congenital hypothyroidism（CH） before and after replacement therapy with L-thyroxine（L-T4 ）, and its relation to pituitary thyroid axis （PTA）. [Methods] The serum leptin concentration was measured by radioimmunoassays（RIA） and serum free triiodothyronine（FT3 ）, free thyroxine（FT4 ）, thyroid stimulating hormone（TSH） concentration were measured by electrochemiluminoimmunoassay（ECLIA）in 23 infants with CH before and after successful L-thyroxine（L-T4 ） replacement therapy,and 46 normal controls that age,sex,body mass index（BMI） matched with CH patients respectively. Statistical analyses were carried out with SPSS 10.0 for windows using simple correlation. [Results] Serum leptin concentration had a positive correlation with FT4 ,a negative correlation with TSH in CH group, but had a negative correlation with FT4 in normal control group. The range of serum leptin concentration changes in CH group was significantly higher than that of normal control group. [Conclusions] and TSH in CH and it does not depend on BMI; detecting the treatment of CH in the future. These results suggest that serum leptin is affected by FT4 serum leptin may be assisted examination method to instruct the treatment of CH in the future.

关 键 词：先天性甲状腺功能减低症 瘦素 甲状腺功能 垂体-甲状腺轴 体质指数 

分 类 号：R722.1[医药卫生—儿科]