摘要
目的研究自身免疫性甲状腺疾病(AITD)病人肾上腺皮质功能变化与肾虚证的相关性。方法随机选取甲状腺球蛋白抗体(TGAb)、甲状腺过氧化酶抗体(TPOAb)阳性病人90例,按照甲状腺功能状态分为甲状腺功能正常组(正常组)、甲状腺功能亢进组(甲亢组)、甲状腺功能减退组(甲减组),每组30例。对照组为30名健康志愿者。分别于08:00、16:00采取静脉血,测定血清皮质醇含量,计算浓度时间曲线下面积(AUC),同时进行心电图测定。所有受试对象根据中医肾阳虚、肾阴虚评分量表进行中医辨证分型。结果与对照组相比,AITD病人甲状腺功能异常组抗体TGAb、TPOAb显著升高(P<0.05或P<0.01);甲减组肾阳虚证者占93.3%,无肾阴虚证;甲亢组肾阴虚证者占66.7%,无肾阳虚证;与正常组和对照组比较差异有统计学意义(P<0.05);AITD组甲减组血清皮质醇含量低于正常组、对照组,差异有统计学意义(P<0.05),甲亢组则轻度低于正常组,但无差异统计学意义。结论 AITD病人甲状腺功能减退者,TPOAb、TGAb显著升高,肾上腺功能水平低下与肾阳虚证呈正相关;及早测定甲状腺素及其自身抗体、肾上腺皮质功能水平,对其早期诊断肾虚证与防治心脑等病变具有重要临床意义。
Objective To study the correlation between adrenal cortical function and kidney deficiency syndrome in patients with autoimmune thyroid disease（ AITD）. Methods Ninety patients with positive thyroglobulin antibody（ TGAb） and thyroid oxidase antibody（ TPOAb） were selected,and divided into normal thyroid function group（ group A,n = 30）,hyperthyroidism group（ group B,n = 30）,hypothyroidism group（ group C,n =30）. Thirty healthy individuals were as controls. The serum cortisol level was detected at 08： 00,16： 00. The area under the concentration time curve（ AUC） was calculated. ECG were determined. The traditional Chinese medicine（ TCM） syndrome types were observed by the scale of kidney- yang deficiency syndrome and kidney-yin deficiency syndrome. Results Compared with the control group,TGAb and TPOAb increased significantly in group B and group C（P〈0. 05 or P〈0. 01）. AITD patients with kidney- yang deficiency syndrome was 93. 3% in group C,and there was no kidney-yin deficiency syndrome. AITD patients with kidney- yin deficiency syndrome was66. 7% in group B,and there was no kidney- yang deficiency syndrome. Serum cortisol levels in group C were lower than that in group A and control group（P〈0. 05）. Conclusion TGAb and TPOAb increase significantly in AITD patients with thyroid dysfunction. The low level of adrenal function is positively correlated with kidney- yang deficiency syndrome. Early determination of thyroid hormone level and its antibody and adrenal cortex function has important clinical significance for the early diagnosis of kidney deficiency syndrome and the prevention and treatment of cardiac and cerebral diseases.
出处
《中西医结合心脑血管病杂志》
2016年第19期2227-2229,共3页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
珠海医学科研基金项目(No.2012039)
