摘要
目的研究慢性丙型肝炎患者(CHC)治疗过程中出现甲状腺自身抗体(TA)特点及TA与甲状腺功能预后间关系。方法收集2010年7月~2016年9月解放军第三〇二医院以干扰素α(INF-α)为基础抗病毒治疗的CHC患者115例,随访中根据临床表现及实验室检查结果 ,分成桥本甲状腺炎(HT)组(HT组)、弥漫性甲状腺肿(GD)组(GD组)以及未进展成自身免疫性甲状腺疾病(AITD)组,另选择乙型病毒性肝炎(HBV)感染伴发AITD患者8例为HBV伴发AITD组,无肝炎病毒感染的单纯AITD患者47例为单纯AITD组。比较各组及甲状腺功能不同转归(缓解组、恶化组)CHC患者TA[包括抗甲状腺球蛋白抗体(TG-Ab)、抗过氧化物酶抗体(TPO-Ab)、促甲状腺激素受体抗体(TRAb)]滴度差异情况。结果 (1)115例CHC患者随访过程中24例(20.9%)发生AITD,5例(4.3%)为GD,19例(16.5%)为HT,GD组、HT组、及未进展成AITD组患者TA水平间差异有高度统计学意义(P<0.01)。(2)HBV伴发AITD组及单纯AITD组TA水平与GD组比较,差异有高度统计学意义(P<0.01),与HT组比较差异无统计学意义(P>0.05)。(3)缓解组(15例)患者TPO-Ab、TRAb均值显著低于恶化组(9例)(P<0.05),缓解组TG-Ab均值略低于恶化组(P>0.05)。结论应用INF-α治疗的CHC患者易诱发AITD,并且TA在不同种类AITD患者中存在各自特点,TPO-Ab、TRAb较TG-Ab可能在患者临床调整治疗方案调整和甲状腺功能预后判断方面更加敏感。
Objective To investigate the character of autoimmune thyroid antibodies （TA） titer and the relationship with prognosis in patients with chronic hepatitis C （CHC） during the treatment. Methods From July 2010 to September 2016, in NO.302 Hospital of PLA, 115 CHC patients received IFN-α therapy were selected, according to clinical presentation and laboratory results, they were divided into Hashimoto＇s thyroiditis group （HT group）, Graves group （GD group） and none AITD group, and 8 patients with HBV infected combine AITD were selected as HBV combine AITD group, 47 AITD patients without hepatitis virus infection were selected as simple AITD group. The titer Of autoimmune thyroid antibodies （TG-Ab, TPO-Ab, TRAb） of all groups and different outcomes （remission group, deterioration group） of CHC patients were compared. Results Among 115 CHC patients, 24 patients （20.9%） occured AITD, 5 cases （4.3%） were GD, 16 cases （16.5%） were HD, TA of HD group, GD group and none AITD group were compared, the differences were statistically significant （P 〈 0.01）.②TA of HBV combine AITD group and simple AITD group were compared with that of GD group, the differences were statistically significant （P 〈 0.01）, these were compared with HD group, the differences were not statistically significant （P 〉 0.05）.③TPO-Ab, TRAb of remission group （15 cases） were significantly lower than that of deterioration group （9 cases） （P 〈 0.05）, TG-Ab of remission group were slightly lower than that of deterioration group （9 cases） （P 〉 0.05）. Conclusion CHC patients received IFN-α therapy are easily progressing into AITD, TAs were different in each kind of AITD, TPO-Ab, TRAb may sensitive than TG-Ab in changing treatment plan and forecasting the thyroid prognosis.
作者
袁孟伟
苑文雯
戴亮
丁扬
王璐瑶
李伯安
王晗
YUAN Mengwei YUAN Wenwen DAI Liang DING Yang WANG Luyao LI Bo＇an WANG Han(Clinical Laboratory Medicine Center, NO.302 Hospital of PLA Clinical Laboratory Diagnosis Center For Infectious Diseases of Army, Beijing 100039, China)
出处
《中国医药导报》
CAS
2017年第5期117-120,共4页
China Medical Herald
基金
北京市自然科学基金资助项目(7154239)
