CAJ | 학술논문

　　目的探讨重型β地中海贫血（地贫）伴铁过载患者甲状腺、甲状旁腺、性腺等内分泌情况。方法重型地贫患者77例（病例组），健康对照组75例，检测两组空腹血糖、空腹胰岛素、血钙、无机磷、铁蛋白及甲状旁腺激素、促甲状腺激素（TSH）、游离三碘甲状腺原氨（FT3）、游离甲状腺素（FT4）、骨钙素。结果病例组检出亚临床甲低18例、甲状旁腺激素低下8例，对照组75例FT3、FT4、TSH均在正常范围。病例组检出胰岛素抵抗4例，对照组无胰岛素抵抗。两组空腹血糖、空腹胰岛素、胰岛素抵抗指数（HOMA-IR）比较差异无统计学意义（P＞0．05）。病例组血钙、甲状旁腺激素均低于对照组（P＜0．05）；血磷、骨钙素、铁蛋白高于对照组（P＜0．05）。病例组骨龄落后、骨质疏松、身高落后、体重低下发生率均高于对照组（P均＜0．05）。结论重型地贫伴铁过载患者内分泌功能损害是多方面的，以身材矮小和性发育迟缓、性激素水平低下最常见，其次是甲状腺和甲状旁腺激素功能低下。
　　목적탐토중형β지중해빈혈（지빈）반철과재환자갑상선、갑상방선、성선등내분비정황。방법중형지빈환자77례（병례조），건강대조조75례，검측량조공복혈당、공복이도소、혈개、무궤린、철단백급갑상방선격소、촉갑상선격소（TSH）、유리삼전갑상선원안（FT3）、유리갑상선소（FT4）、골개소。결과병례조검출아림상갑저18례、갑상방선격소저하8례，대조조75례FT3、FT4、TSH균재정상범위。병례조검출이도소저항4례，대조조무이도소저항。량조공복혈당、공복이도소、이도소저항지수（HOMA-IR）비교차이무통계학의의（P＞0．05）。병례조혈개、갑상방선격소균저우대조조（P＜0．05）；혈린、골개소、철단백고우대조조（P＜0．05）。병례조골령락후、골질소송、신고락후、체중저하발생솔균고우대조조（P균＜0．05）。결론중형지빈반철과재환자내분비공능손해시다방면적，이신재왜소화성발육지완、성격소수평저하최상견，기차시갑상선화갑상방선격소공능저하。
ObjectiveToexploretheendocrineofthyroid,parathyroid,gonadinβ-thalassemiamajorpatients withironoverload.Methods Seventy-sevenpatientswiththalassemiamajor(casegroup)and75casesofhealthy controls(controlgroup)wereenrolledinthestudy.Fastingbloodglucose,fastinginsulin,serumcalcium,phosphorus andferritinweredetectedinbothgroupsaswellasparathyroidhormone,TSH,FT3,FT4 andosteocalcin.Results Therewere18casesofsubclinicalhypothyroidism and8casesoflowparathyroidhormoneinthecasegroup.FT3,FT4 andTSHof75casesinthecontrolgroupwerenormal.Therewere4insulinresistancecasesinthecasegroupwhile noinsulinresistancecaseinthecontrolgroup.Fastingbloodglucose,fastinginsulin,HOMA-IRshowednosignificant differencebetweentwogroups(P>0.05).Serumcalciumandparathyroidhormoneofpatientsinthecasegroupwere lowerthanthoseinthecontrolgroup(P<0.05);Serumphosphorus,osteocalcinandferritinofpatientsinthecase groupwerehigherthanthoseinthecontrolgroup(P<0.05).Theincidencesofboneagelag,osteoporosis,shortsta-ture,andlowweightinthecasegroupwerehigherthanthoseinthecontrolgroup(allP>0.05).Conclusion Per-formanceofβ-thalassemiamajorcompaniedbyironoverloadisassociatedwithendocrinedysfunctioninmanyaspects, whichmainlypresentsshortstature,delayedpubertyandlowsexhormonelevel,andthenthyroidandparathyroidhy-pofunction.