衰老对于心脏传导系统的变化在临床方面表现为老年人常见的窦房结功能障碍和各种心律失常,包括房性早搏、室性早博、心房颤动(AF)、房室传导阻滞(AV阻滞)等.与年轻人相比,老年人发生心律失常的概率较高,而且老年人发生的阵发性室上性心动过速(PSVT)、室性心动过速(VT)及室内传导阻滞主要伴随心脏结构性病变发生,多数与老年共病及并发症有关,如高血压、冠心病(CAD)、心力衰竭等,但在无结构性心脏疾病的老年人中也常见心律失常,并引起晕厥.

Objective To explore the relationship between urine albumin creatine ratio(ACR) and serum thyrotropin(TSH).Methods In October 2007,a total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and measure the blood pressure,height,weight and waist.The vein blood was drawn to measure thyrotropin(TSH),thyroid peroxidase antibody(TPOAb),Thyroglobulin antibody(TGAb),fasting plasma glucose(FPG),OGTT 30minPG,OGTT 2hPG,fasting insulin,triglyceride(TG),total cholestoral(TC),high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C).Fasting urine samples were collected for measurement of creatinine and microalbumin,and the microalbumin/creatinine ratio(ACR) was calculated.Results The prevalence of microalbuminuria was 11.8% and was increasing with age(P0.01).Compared with subjects with normal microalbumin,the waist,BMI,systolic pressure,diastolic pressure,heart rate,FPG,OGTT 30minPG,OGTT 2hPG,serum TG,and homeostasis model assessment insulin resistance(HOMA-IR) were all significantly increased in subjects with microalbuminuria(P0.05).However serum TSH,the prevalence of subclinical hypothyroidism and hyperthyroidism was no statistical difference between the two groups(P0.05).Hyperglycemia and hypertension was independently associated with the prevalence of microalbuminuria(hypertension OR=1.868,P0.01;hyperglycemia OR=1.469,P0.05).Conclusion ACR was not related with serum TSH,while the hyperglycemia and hypertension was independently associated with the prevalence of microalbuminuria.

OBJECTIVE:With the introduction of iodized salt worldwide, more and more people are exposed to more than adequate iodine intake levels with median urinary iodine excretion (MUI 200-300 μg/l) or excessive iodine intake levels (MUI >300 μg/l). The objective of this study was to explore the associations between more than adequate iodine intake levels and the development of thyroid diseases (e.g. thyroid dysfunction, thyroid autoimmunity, and thyroid structure) in two Chinese populations.DESIGN:A population-based cross-sectional study was conducted in two areas in which people are exposed to different levels of iodine intake (Rongxing, MUI 261 μg/l; Chengshan, MUI 145 μg/l). A total of 3813 individuals were recruited by random sampling. Thyroid hormones, thyroid autoantibodies in serum, and iodine levels in urine were measured. B-mode ultrasonography of the thyroid was also performed for each participant.RESULTS:The prevalence of subclinical hypothyroidism was significantly higher for subjects who live in Rongxing than those who live in Chengshan (5.03 vs 1.99%, P<0.001). The prevalence of positive anti-thyroid peroxidase antibody (TPOAb) and positive anti-thyroglobulin antibody (TgAb) was significantly higher for subjects in Rongxing than those in Chengshan (TPOAb: 10.64 vs 8.4%, P=0.02; TgAb: 10.27 vs 7.93%, P=0.01). The increase in thyroid antibodies was most pronounced in the high concentrations of TPOAb (TPOAb: ≥500 IU/ml) and low concentrations of TgAb (TgAb: 40-99 IU/ml) in Rongxing.CONCLUSIONS:More than adequate iodine intake could be a public health concern in terms of thyroid function and thyroid autoimmunity in the Chinese populations.

Objectlve To study the MEN1 gene mutation in two cases of multiple endocrine neoplasia type 1.Methods Genomic DNA was extracted from the peripheral blood lymphocytes of patients.PCR was performed to amplify 9 exons of MEN1 gene.The PCR products were directly sequenced.Results A heterozygote C to T teansition was detected in c.1378 within exon 10 in one patient;No mutation was found in the entire MEN1 gene coding region of the other patient.Conclusion The mutation of c.1378C＞T(Arg460Ter) in MEN1 gene is one type of MEN gene mutations in China.

目的 探讨血清促甲状腺激素(TSH)与代谢综合征(MS)及其组分的关系.方法 2007年10月在沈阳市大东区分层抽样调查1534人,详细填写流行病学调查表格,测量血压、身高、体重及腰围,采集血样测定TSH、空腹血糖(FPG)、胰岛素浓度、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C).结果 MS组血清TSH明显高于非MS组(2.54 mU/L对2.22 mU/L,P<0.05);亚临床甲减组TG明显高于甲状腺功能正常组[(1.73±0.12)mmol/L对(1.47±0.03)mmol/L,P<0.05],HDL-C明显低于甲状腺功能正常组[(1.26±0.27)mmol/L对(1.33±0.27)mmol/L,P<0.05];亚临床甲减组高血压患病率明显高于甲状腺功能正常组(42.86%对33.2%,P<0.05).正常范围内血清TSH与超重或肥胖的患病危险显著相关(P=0.001).结论 甲状腺功能轻度降低发生代谢综合征的危险性增加.