摘要
目的探讨桥本甲状腺炎(Hashimoto's thyroiditis,HT)甲状腺功能减退(甲减)患者应用左甲状腺素钠片治疗前及治疗5个月后血清1,25-二羟维生素D_3[l,25 2-hydroxyvitamin D_3,1,25(OH)_2D_3]、白细胞介素-8(interleukin-8,IL-8)水平变化及意义。方法 HT甲减患者58例为观察组,同期体检健康者58例为对照组。观察组给予左甲状腺素钠片150~200μg/d,连续口服5个月,对照组不作处理。对照组于入组时,观察组于治疗前及治疗5个月后采用光化学分析法检测血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free tetraiodothyron,FT4)、促甲状腺激素(thyroid stimulating hormone,TSH)水平,采用放射免疫分析法检测血清促甲状腺素受体抗体(thyrotropin receptor antibody,TRAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)水平,采用ELISA法检测血清IL-8、1,25(OH)_2D_3水平,并与对照组进行比较;Pearson法分析观察组血清IL-8、1,25(OH)_2D_3水平与FT_3、FT_4等指标的相关性。结果观察组治疗前血清FT_4[(9.55±5.27)pmol/L]、1,25(OH)_2D_3[(22.61±7.28)μg/L]均低于对照组[(19.70±6.20)pmol/L、(33.62±6.19)μg/L],血清TSH[(5.86±1.28)u/L]、TPOAb[(558.65±89.96)u/mL]、TgAb[(203.26±16.08)%]、IL-8[(114.62±16.78)ng/L]均高于对照组[(2.73±0.17)u/L、(45.12±0.85)u/mL、(38.23±12.39)%、(90.36±18.24)ng/L](P<0.05),血清FT3[(5.26±1.57)pmol/L]、TRAb[(0.15±0.05)u/L]与对照组[(4.98±1.04)pmol/L、(0.12±0.07)u/L]比较差异均无统计学意义(P>0.05);治疗5个月后,观察组血清FT_4[(17.14±3.22)pmol/L]、1,25(OH)_2D_3[(31.14±8.32)μg/L]均高于治疗前(P<0.05),血清TSH[(3.18±1.04)u/L]、TPOAb[(61.24±13.29)u/mL]、TgAb[(42.98±11.84)%]、IL-8[(93.16±12.34)ng/L]均低于治疗前(P<0.05),血清FT_3[(5.11±1.14)pmol/L]、TRAb[(0.13±0.08)u/L]与治疗前比较差异均无统计学意义(P>0.05);Pearson相关性分析结果显示,观察组血清IL-8与TSH、TPOAb水平呈正相关(r=0.520,P=0.002;r=0.398,P=0.025),血清1,25(OH)_2D_3与TSH、TPOAb水平呈负相关(r=-0.408,P=0.021;r=-0.415,P=0.020)。结论HT甲减患者血清IL-8水平升高,1,25(OH)_2D_3水平降低,且与TSH和TPOAb水平相关。
Objective To investigate the changes and significances of serum l,25-dihydroxyvitamin D3（1,25（OH）2D3）and interleukin-8（IL-8）before and after 5-month treatment with levothyroxine sodium tablets in patients with Hashimoto＇s thyroiditis（HT）and hypothyroidism.Methods Fifty-eight patients with HT and hypothyroidism（observation group）received oral levothyroxine sodium tablets 150-200μg/d for 5 months.Another 58 healthy volunteers（control group）received no treatment.The serum levels of free triiodothyronine（FT3）,free tetraiodothyron（FT4）and thyroid stimulating hormone（TSH）were measured by photochemical methods,the levels of thyrotropin receptor antibody（TRAb）, thyroid peroxidase antibody（TPOAb） and thyroglobulin antibody（TgAb） were detected by radioimmunoassay,and the serum levels of IL-8 and 1,25（OH）2D3 were detected by ELISA method in observation group before treatment and after 5-month treatment and compared with control group.The correlations of serum IL-8 and1,25（OH）2D3 levels with FT3 and FT4 were analyzed by Pearson method.Results Before treatment,the levels of FT4（（9.55±5.27）pmol/L）and 1,25（OH）2 D3（（22.61±7.28）μg/L）in observation group were significantly lower than those in control group（（19.70±6.20）pmol/L,（33.62±6.19）μg/L）（P〈0.05）,the serum levels of TSH（（5.86±1.28）u/L）,TPOAb（（558.65±89.96）u/mL）,TgAb（（203.26±16.08）%）and IL-8（（114.62±16.78）ng/L）were significantly higher than those in control group（（2.73±0.17）u/L,（45.12±0.85）u/mL,（38.23±12.39）%,（90.36±18.24）ng/L）（P〈0.05）,and there were no significant differences in the serum levels of FT3 and TRAb between observation group（（5.26±1.57）pmol/L,（0.15±0.05）u/L）and control group（（4.98±1.04）pmol/L,（0.12±0.07）u/L）（P〉0.05）.After 5-month treatment,the serum levels of FT4（（17.14±3.22）pmol/L）and 1,25（OH）2 D3（（31.14±8.32）μg/L）in observation group were significantly higher than those before treatment（P〈0.05）,the serum levels of TSH（（3.18±1.04）u/L）,TPOAb（（61.24±13.29）u/mL）,TgAb（（42.98±11.84）%）and IL-8（（93.16±12.34）ng/L）were significantly lower than those before treatment（P〈0.05）,and there were no significant differences in the serum levels of FT3（（5.11±1.14）pmol/L）and TRAb（0.13±0.08）u/L）in observation group after treatment in comparison with those before treatment（P〉0.05）.Pearson correlation analysis showed that serum IL-8 level was positively correlated with TSH and TPOAb（r=0.520,P=0.002;r=0.398,P=0.025）,and 1,25（OH）2D3 was negatively correlated with TSH and TPOAb（r=-0.408,P=0.021;r=-0.415,P=0.020）in observation group.Conclusion The increased IL-8 and decreased 1,25（OH）2D3 levels are correlated with TSH and TPOAb contents in patients with HT and hypothyroidism.
作者
尚敬
于璐
李全忠
袁慧娟
SHANG Jing;YU Lu;LI Quan-zhong;YUAN Hui-juan(Department of Endocrinology, Henan Provincial People＇s Hospital, People＇s Hospital of Zhengzhou University, Zhengzhou 450003, Chin)
出处
《中华实用诊断与治疗杂志》
2018年第6期575-577,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省科技攻关项目(152102310123)
