摘要
目的探讨不同碘摄入量对结节性甲状腺肿(结甲)患者自身免疫功能的影响。方法选取2009年9月—2010年9月就诊于我院的居住于沧州的结甲患者70例,依据患者尿碘中位数分为结甲Ⅰ组(尿碘≥487.8μg/L)32例与结甲Ⅱ组(尿碘<487.8μg/L)38例,另选取同期在我院体检中心体检的健康者49例为对照组。分别测定并比较3组受检者的甲状腺功能〔游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)〕、甲状腺球蛋白(TG)及甲状腺自身抗体〔甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)〕。结果对照组、结甲Ⅰ组、结甲Ⅱ组受检者FT3〔(5.3±1.1)、(2.6±0.8)、(3.8±1.1)pmol/L〕、FT4〔(16.4±3.2)、(8.4±0.5)、(13.1±0.4)pmol/L〕、TSH〔(1.7±0.8)、(2.6±1.2)、(1.5±0.8)mU/L〕、TG〔(31.8±45.2)、(59.3±50.5)、(49.1±47.3)μg/L〕及TPOAb阳性率(18.4%、43.7%、21.1%)、TGAb阳性率(12.2%、46.9%、23.7%)比较,差异均有统计学意义(P<0.05);其中结甲Ⅰ组患者FT3、FT4水平低于对照组及结甲Ⅱ组,TSH水平及TPOAb、TGAb阳性率高于对照组及结甲Ⅱ组,TG水平高于对照组,组间比较差异有统计学意义(P<0.05);结甲Ⅱ组患者FT3、FT4水平低于对照组,TG水平高于对照组,差异亦有统计学意义(P<0.01)。相关分析显示,TGAb与TPOAb均呈直线正相关(r=0.526,P<0.01);TG与TPOAb、TGAb均呈直线正相关(r值分别为0.420和0.262,P<0.05)。结论高碘摄入会引发结甲患者的免疫功能紊乱,故应限制高碘地区结甲患者的碘摄入量。
Objective To investigate the effect of different levels of iodine intake on autoimmune in nodular goiter （NG） cases. Methods 70 NG patients （permanent residents of Cangzhou） admitted to our hospital from September 2009 to September 2010 were divided into NG group Ⅰ （urine iodine ≥487.8μg/L） and rqG group1Ⅱ （urine iodine 〈 487.8μg/L） according to urine iodine median 487. 8 μg/L. Another 49 healthy people underwent physical examination in the same period were involved as control group. Thyroid function （FT3, FT4, TSH, TG and thyroid auto - antibodies of TPOAb and TGAb） of the three groups was detected. Results TheFT3 [ （5.3±1.1）, （2.6±0.8）and （3.8±1.1） pmol/L], FT4 [ （16.4± 3.2）, （8.4±0.5）and （13.1±0.4）pmol/L], TSH [（1.7±0.8）, （2.6±1.2）and （1.5]0.8）mU/L], TG [（31.8 ±45.2）, （59.3 ±50.5） and （49. 1 ±47.3） μg/], positive rate of TPOAb （18.4%, 43.7% and 21.1%） and positive rate of TGAb （12. 2%, 46. 9% and 23.7% ） between control group, group Ⅰ and groupⅡ all showed statistically significant differences （P 〈 0.05）. The FT3 and FT4 in group Ⅰ were significantly lower than control group and group Ⅱ , the TSH and positive rates of TPOAb and TGAb in group Ⅰ were significantly higher than control group and group H, and the TG of group Ⅰ was significantly higher than control group （P 〈 0.05）. The FT3 and FT4 in group Ⅱ were significantly lower than control group, while the TG level in group Ⅱ was significantly higher than control group （P 〈 0. 01 ）. Correlation analysis showed that TGAb was positively correlated with TPOAb （r = 0. 526, P 〈0. 01 ）, TG was positively correlated with TPOAb and TGAb （r = 0. 420 and 0. 262, P 〈 0.05）. Conclusion Excessive iodine intake can aggravate the immune dysfunction in patients with nodular goi- ter, so the intake of iodine should be limited in patients with nodular goiter.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第5期487-489,共3页
Chinese General Practice
