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BIN I NNG ESTRADIOL BNH NHN N CNG GIP

Trn B ThoiBnh vin Nng

CHANGE OF SERUM ESTRADIOLCONCENTRATION IN FEMALE

PATIENTS WITHHYPERTHYROIDISM .

Thyroid is an important endocrinologicgland. Its hormones affect on many otherorgans, systems and functions of human

body.Receptor of T3, the active form of

thyroid hormone, is one of a "family" ofreceptors similar to the nuclear receptorsfor glucocorticoides, estrogens and

progestin.Our study was carried out on 37 women

of hyperthyroid patients age of 15 to 45,were diagnosed by physical examinationand laboratory analysing for T3, T4 andTSH concentration.

The obtained results showed that:- All of hyperthyroid women have a

significanthy increase in serumconcentration of estradiol (average 39 s 21

pg/ml)

- There was no relationship between theincrease of estradiol level with the changesof serum concentration of T3, T4 and TSH.

Tm tt:Tuyn gip l mt tuyn ni tit quan

trng. N chi phi nhiu c quan, hthng, chc nng trong c th con ngi.Hormones tuyn gip c cng h th thvi cc hormones sinh dc v thng thn.

Chng ti nghin cu s thay i nng Estradiol trn 37 bnh nhn n tui t15 n 45 mi c chn on cng gipqua khu lm sng v cc xt nghim sinhha - o nng T3, T4 v TSH.

Kt qu thu c cho thy:- Nng Estradiol huyt thanh u

tng dn, cao hn bnh thng tt c 37bnh nhn theo di (39 s 21 pg/ml)

- S tng nng Estradiol huyt thanhny khng c tng quan vi s thayi nng T3, T4 v TSH.

1. T VN :Tuyn gip l tuyn ni tit quan trng v n chi phi nhiu c quan, h thng khc trong

c th ngi. Do nhng bnh l tuyn gip cng c th nh hng ln nhiu qu trnh khctrong c th nh: chuyn ha nng lng, chuyn ha cacbohydrate, h tun hon, h thnkinh, h sinh dc, h c xng khp v.v...

Cng gip chim t l cao trong bnh l tuyn gip ni ring v trong bnh l ni tit nichung.

T l mc cng gip n gp 7 n 8 ln so vi nam gii v tui mc bnh l tui

sinh sn t 15 n 45 tui.Chc nng sinh sn ca n gii lin h cht ch vi chc nng bung trng. Chc nng

bung trng gm hai phn: to ra trng v tit cc hormones.Estradiol E2 l mt thng s quan trng nh gi chc nng ni tit sinh dc ca bung

trng. Thng nng estradiol thp trong cc trng hp dy th mun, v kinh nguynpht v mn kinh.

Chng ti lm nghin cu ny bc u nhm hai mc tiu:- Xc nh s thay i nng Estradiol bnh nhn n b cng gip.- Tm tng quan gia thay i ny vi cc thay i hormone tuyn gip.

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2. I TNG V PHNG PHP NGHIN CU:2.1 i tng nghin cu:- L 37 bnh nhn n c xc nh cng gip qua khm lm sng v xt nghim ti

khoa Ni C v khoa Sinh ha Bnh vin a Khoa Nng.- Tui t 15 n 45.

- Khng dng thuc c ni tit n.- C chu k kinh nguyt tng i u.- Khng mc bnh km c lin quan n ni tit sinh dc n.

2.2 Phng php nghin cu:2.2.1 Khm lm sng - lp h s hnh chnh.2.2.2 2.2.2 Xt nghim sinh ha.

2.2.2.1 nh lng T3, T4 v TSH:Dng phng php ELISA vi kit thuc th, qui trnh v my o ca hng

HUMAN Germany.2.2.2.2 nh lng Estradiol E2:Dng phng php ELISA vi kit thuc th, qui trnh k thut v my o ca

HUMAN Germany.

2.3 X l s liu:Theo phng php thng k y hc, c h tr bi Excel 2000.

3. KT QU:3.1 Nng hormones tuyn gip T3, T4 v TSH

Hormones Trung bnh lch chunT3 ng/ml 5,62 2,01T4 Qg/dl 23,32 6,81

TSH mIU/l 0,22 0,41

3.2 Chnh lch nng Estradiol so vi chun:Trong 37 bnh nhn n cng gip cha iu tr chng ti thu c kt qu nh sau:

Nhm S lng chnh lch lch chun16 25 tui 9 37 1426 35 tui 10 52 3036 45 tui 18 33 16Tng cng 37 39 21

Tt c 37 bnh nhn nghin cu u c nng Estradiol tng so vi chun c cngngy ca chu k kinh nguyt.Nhm c nng Estradiol tng nhiu nht l nhm t 26 n 35 tui.

3.3 H s tng quan gia chnh lch Estradiol vi T3, T4 v TSH

Hormones r pT3 0,12 < 0,01T4 0,05 < 0,01

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TSH 0,33 < 0,01

Khng c s tng quan gia chnh lch nng Estradiol vi nng T3, T4 vTSH.

4. NHN XT V BN LUN:

Ngi ta bit hormones tuyn gip c cng h th th vi hormones sinh dc. Hn nahormones tuyn gip nh hng ln nhiu c quan, h thng... trong c th con ngi.

Qua nghin cu trn 37 bnh nhn cng gip chng ti thy nng Estradiol u tngso vi chun c cng ngy trong chu k kinh nguyt, chnh lch ny c ngha thng k.

Kt qu ny ph hp vi cc kt qu ca Maran P.R, Larsen P.R. Davies T.F v Hay I.D.S tng Estradiol ny c th hoc do tng TeBG (Testosterone Binding Globulin) hoc do

tng chuyn i androgens ra estrogens.

TI LIU THAM KHO

1. ng Th Ngc Dung (1996) Tc dng ca hormone tuyn gip v c ch iu haBnh tuyn gip v cc ri lon do thiu Tode, Nxb Y hc 52_59.

2. Dng Th Nguyt Minh (2000) Nghin cu hm lng kch dc t tuyn yn vhormone bung trng trn nhng bnh nhn v kinh v sinh khng phng non bng k thut

RIA. K yu cng trnh nghin cu khoa hc Ni tit v chuyn ha, Nxb Y hc 560_4.3. Abe Y (1997) Thyroid diseases and reproduction dysfunction Nippon Rinsho 1997,

Nov 55(11) 2974_8.4. Dumonlin S.C (1995) O pposite effects of thyroid hormones on binding proteins for

steroid hormones (sex hormone binding globulin and corticosteroid binding globulin) inhumans Eur. J. Eudocinol 1995 May, 132(5) 594_8.

5. Greenspan F.S, Baxter J.D (1999) The thyroid gland Basic and clinicalEndocrinology 5th Ed Prentice, Hall International 192_262.

6. Human (2000) Estradiol E2 (EIA) Ti liu hng dn k thut.

7. Krassas G.E (2000) Thyroid disease and female reproduction

Fertil steril 2000 Dec74(6) 1063_70.8. Krassas G.E (1999) Disturbances of menstruation in hypothyroiddism clin Endocinol

(oxf) 1999 May 50(5) 655_9.9. Larsen P.R.Davies T-F, Hay I.D (2001) The thyroid gland Williams textbook of

Endocrinology 9th Ed Saunders 389_515.10. Maran RR (2000) T3 directly stimulates basal and modulates LH in duced

Testosterone and estradiol production by rat Leydig cells in vitro Endocri J 2000 Aug 47(4)417_28.

11. Tagawa N (2001) Serum concentration of an drostenediol in patients withhyperthyroidism and hypothyroidism Clin Chem 2000 Apr 46(4) 523_8.

12. Vierhapper H. (1998) Normal serum concentration of sex hormone binding-globulin

in patients with hyperthyroidism due to subacute thyroiditis

Thyroid 1998 Dec 8(12)1107_11.