滤纸片法TRH兴奋试验在碘缺乏病中的应用  

TRH Stimulation Test Modified by Blood Filter Paper Method in Application study on IDD in Xinjiang

作　　者：依麻木 玛丽亚[1] 蒋继勇[1] 杨成忠[1] 林法福[1] 

机构地区：[1]新疆地方病防治研究所,喀什地区卫生防疫站

出　　处：《地方病通报》1996年第2期74-78,共5页Endemic Diseases Bulletin

摘　　要：本文将血清法ＴＲＨ兴奋试验改为血滤纸片法，在新疆严重碘缺乏病区测定地方性克汀病２６例，其中粘肿型１０例、混合型１０例、神经型６例。滤纸片法ＴＲＨ兴奋试验结果：基础ＴＳＨ值（ＴＳＨ０）、ＴＳＨ峰值（注射ＴＲＨ３０，钟后的最高值ＴＳＨ３０，）、△ＴＳＨ绝对增值（ＴＳＨ３０，峰值减ＴＳＨ０）对不同类型的克汀病人分别为：粘肿型ＴＳＨ０１２０．２９±９３．７４μＩＵ／ｍｌ、ＴＳＨ３０，２２５．３０±１１２．０７μＩＵ／ｍｌ、△ＴＳＨ１０５．０１μＩＵ／ｍｌ；混合型ＴＳＨ０１０．５８±９．３６μＩＵ／ｍｌ、ＴＳＨ３０，６４．７８±３３．９８μＩＵ／ｍｌ；△ＴＳＨ５４．２０μＩＵ／ｍｌ；神经型ＴＳＨ０１．９８±０．６３μＩＵ／ｍｌ、ＴＳＨ３０，２６．７６±４９．９２μＩＵ／ｍｌ、△ＴＳＨ２４．７６μＩＵ／ｍｌ。三型克汀病间差异显著（Ｐ＜０．０１）．粘肿型克汀病ＴＳＨ对ＴＲＨ兴奋试验的应答反应呈超常强反应型，峰值呈持续状态，混合型次之，神经型呈弱或延迟反应型。另外还测定了８～１０岁不同组别的儿童８９例，ＴＲＨ兴奋试验结果分别为：２８例正常对照组的ＴＳＨ０、ＴＳＨ３０，各为３．５５±０．９８μＩＵ／ｍｌ、３０．４８±１１．４?TRH stimulation test modified by using blood filter paper instead of sera was used to examine26 patients with cretinism,including 10 myxedematous,10 mixed and 6 neurological type in shache county,thesevere IDD endemic area of Xinjiang. In the filter paper method-TRH stimulation test,basic value(TSH0),peak value(TSH30,which is the maximum after TRH injection 30 minutes),and absolute value(△TSH,TSH30,一TSH0)of TSH were detected in patients with the three types of cretinism mentioned above. TSH0,TSH30,and △TSH were 120.29±93.74 μIU/ml ,225.30±112.07μIU/ml and 105.01 μIU/ml of the myxede-matous ,as well as 10.58±9.36 μIU/ml ,64.78±33.98 μIU/ml ,54.20μIU/ml of the mixed type,1.98±0.63μIU/ml,26.76 ± 49.92 μIU/ml,24.76 μIU/ml of the neurological respectively. There was significant differ-ence in three types of cretinism(P<0.01).TSH in the myxedematous responded to TRH test super-stronglyand its peak value kept continuously. The response of TSH in the neurological was weak or delayed reactionwhile in mixed type it was less than that in the myxedematous. On the other hand,89 children aged 8～10 indifferent groups were also examined by the test. Results showed that TSH0,TSH30,were 3.55±0.98 μIU/ml,30.48±11.74 μIU/ml in 28 cases of normal group,4.55±4.48 μIU/ml,24. 93±6.50μIU/ml in 30 cases ofsubclinical cretinism group and 2.84± 1.50 μIU/ml,33.00± 19.75 μIU/ml in 31 cases of goiter group.TSH0of children in subclinical group was higher than that in the normal with no obvious difference(P>0.05),and10%of children’s TSH in subclinical group was strong reaction to the TRH test.The response peak value ofTSH of the goiter children was higher than that of the normal without significant difference(P>0.05 ).Therefore,TRH stimulation test is important for diagnosing and typing cretinism,and the modified test byblood filter paper will be used widely and conveniently in the epidemiological survey of IDD.

关 键 词：碘缺乏 血滤纸片法 TRH兴奋试验 地方性克汀病 

分 类 号：R591.104[医药卫生—内科学]