BI N I N NG B NH NHN N

ESTRADIOL C NG GIP
Tr n B Tho i B nh vi n N ng

CHANGE OF SERUM ESTRADIOL CONCENTRATION IN FEMALE PATIENTS WITH HYPERTHYROIDISM . Thyroid is an important endocrinologic gland. Its hormones affect on many other organs, systems and functions of human body. Receptor of T3, the active form of thyroid hormone, is one of a "family" of receptors similar to the nuclear receptors for glucocorticoides, estrogens and progestin. Our study was carried out on 37 women of hyperthyroid patients age of 15 to 45, were diagnosed by physical examination and laboratory analysing for T3, T4 and TSH concentration. The obtained results showed that: - All of hyperthyroid women have a significanthy increase in serum concentration of estradiol (average 39 s 21 pg/ml)

- There was no relationship between the increase of estradiol level with the changes of serum concentration of T3, T4 and TSH. Tm t t: Tuy n gip l m t tuy n n i ti t quan tr ng. N chi ph i nhi u c quan, h th ng, ch c n ng trong c th con ng i. Hormones tuy n gip c cng h th th v i cc hormones sinh d c v th ng th n. Chng ti nghin c u s thay i n ng Estradiol trn 37 b nh nhn n tu i t 15 n 45 m i c ch n on c ng gip qua khu lm sng v cc xt nghi m sinh ha - o n ng T3, T4 v TSH. K t qu thu c cho th y: - N ng Estradiol huy t thanh u t ng d n, cao h n bnh th ng t t c 37 b nh nhn theo di (39 s 21 pg/ml) - S t ng n ng Estradiol huy t thanh ny khng c t ng quan v i s thay i n ng T3, T4 v TSH.

1. TV N : Tuy n gip l tuy n n i ti t quan tr ng v n chi ph i nhi u c quan, h th ng khc trong c th ng i. Do nh ng b nh l tuy n gip c ng c th nh h ng ln nhi u qu trnh khc trong c th nh : chuy n ha n ng l ng, chuy n ha cacbohydrate, h tu n hon, h th n kinh, h sinh d c, h c x ng kh p v.v... C ng gip chi m t l cao trong b nh l tuy n gip ni ring v trong b nh l n i ti t ni chung. T l m c c ng gip n g p 7 n 8 l n so v i nam gi i v tu i m c b nh l tu i sinh s n t 15 n 45 tu i. Ch c n ng sinh s n c a n gi i lin h ch t ch v i ch c n ng bu ng tr ng. Ch c n ng bu ng tr ng g m hai ph n: t o ra tr ng v ti t cc hormones. Estradiol E2 l m t thng s quan tr ng nh gi ch c n ng n i ti t sinh d c c a bu ng tr ng. Th ng n ng estradiol th p trong cc tr ng h p d y th mu n, v kinh nguyn pht v mn kinh. Chng ti lm nghin c u ny b c u nh m hai m c tiu: - Xc nh s thay i n ng Estradiol b nh nhn n b c ng gip. - Tm t ng quan gi a thay i ny v i cc thay i hormone tuy n gip.

IT NG V PH NG PHP NGHIN C U: 2.1 i t ng nghin c u: - L 37 b nh nhn n c xc nh c ng gip qua khm lm sng v xt nghi m t i khoa N i C v khoa Sinh ha B nh vin a Khoa N ng. - Tu i t 15 n 45. - Khng dng thu c c n i ti t n . - C chu k kinh nguy t t ng i u. - Khng m c b nh km c lin quan n n i ti t sinh d c n . 2. 2.2 Ph ng php nghin c u: 2.2.1 Khm lm sng - l p h s hnh chnh. 2.2.2 2.2.2 Xt nghi m sinh ha. 2.2.2.1 nh l ng T3, T4 v TSH: Dng ph ng php ELISA v i kit thu c th , qui trnh v my o c a hng HUMAN Germany. 2.2.2.2 nh l ng Estradiol E2: Dng ph ng php ELISA v i kit thu c th , qui trnh k thu t v my o c a HUMAN Germany. 2.3 X l s li u: Theo ph ng php th ng k y h c, c h tr b i Excel 2000. 3. K T QU : 3.1 N ng hormones tuy n gip T3, T4 v TSH Hormones T3 ng/ml T4 Qg/dl TSH mIU/l Trung bnh 5,62 23,32 0,22 l ch chu n 2,01 6,81 0,41 c k t qu nh sau: l ch chu n 14 30 16 21

3.2 Chnh l ch nng Estradiol so v i chu n: Trong 37 b nh nhn n c ng gip ch a i u tr chng ti thu Nhm 16 25 tu i 26 35 tu i 36 45 tu i T ng c ng S l ng 9 10 18 37 chnh l ch 37 52 33 39

T t c 37 b nh nhn nghin c u u c n ng Estradiol t ng so v i chu n c cng ngy c a chu k kinh nguy t. Nhm c n ng Estradiol t ng nhi u nh t l nhm t 26 n 35 tu i. 3.3 H s t ng quan gi a chnh l ch Estradiol v i T3, T4 v TSH r 0,12 0,05 p < 0,01 < 0,01

Hormones T3 T4

TSH Khng c s t TSH. ng quan gi a

0,33 chnh l ch n ng

< 0,01 Estradiol v i n ng T3, T4 v

4. NH N XT V BN LU N: Ng i ta bi t hormones tuy n gip c cng h th th v i hormones sinh d c. H n n a hormones tuy n gip nh h ng ln nhi u c quan, h th ng... trong c th con ng i. Qua nghin c u trn 37 b nh nhn c ng gip chng ti th y n ng Estradiol u t ng so v i chu n c cng ngy trong chu k kinh nguy t, chnh l ch ny c ngh a th ng k. K t qu ny ph h p v i cc k t qu c a Maran P.R, Larsen P.R. Davies T.F v Hay I.D. S t ng Estradiol ny c th ho c do t ng TeBG (Testosterone Binding Globulin) ho c do t ng chuy n i androgens ra estrogens. TI LI U THAM KH O 1. ng Th Ng c Dung (1996) Tc d ng c a hormone tuy n gip v c ch i u ha B nh tuy n gip v cc r i lo n do thi u Tode, Nxb Y h c 52_59. 2. D ng Th Nguy t Minh (2000) Nghin c u hm l ng kch d c t tuy n yn v hormone bu ng tr ng trn nh ng b nh nhn v kinh v sinh khng phng non b ng k thu t RIA. K y u cng trnh nghin c u khoa h c N i ti t v chuy n ha, Nxb Y h c 560_4. 3. Abe Y (1997) Thyroid diseases and reproduction dysfunction Nippon Rinsho 1997, Nov 55(11) 2974_8. 4. Dumonlin S.C (1995) Opposite effects of thyroid hormones on binding proteins for steroid hormones (sex hormone binding globulin and corticosteroid binding globulin) in humans Eur. J. Eudocinol 1995 May, 132(5) 594_8. 5. Greenspan F.S, Baxter J.D (1999) The thyroid gland Basic and clinical Endocrinology 5th Ed Prentice, Hall International 192_262. 6. Human (2000) Estradiol E2 (EIA) Ti li u h ng d n k thu t. 7. Krassas G.E (2000) Thyroid disease and female reproduction Fertil steril 2000 Dec 74(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 with hyperthyroidism 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.