摘要
目的通过分析CD8^(+)T淋巴细胞、甲状腺相关激素水平与HT患者的患病风险及预后的关系,为临床选择提供客观依据。方法选取2017年12月至2019年3月于我院内分泌科门诊住院治疗的HT患者112例为研究对象。依据HT患者的患病风险评估,将所有患者分为风险组(n=42)和安全组(n=70),相关性统计分析HT患者CD8^(+)T淋巴细胞水平、甲状腺相关激素水平与临床病理特征的关系。采用单元Cox风险回归模型分析HT患者患病的各因素与预后的关系。结果风险组患者的年龄、BMI、碘过量、硒缺乏、维生素D缺乏、情志、TSH、T_(3)、T_(4)明显高于安全组,CD8^(+)T淋巴细胞数低于安全组,差异均具有统计学意义(均P<0.05);生存曲线分析显示,低水平的CD8^(+)T淋巴细胞数、高水平的TSH、T_(3)、T_(4)的HT患者生存率较好(P<0.05);HT患者的甲状腺组织CD8^(+)淋巴细胞数,发现年龄、BMI、碘过量、硒缺乏、维生素D缺乏、情志均是CD8^(+)淋巴细胞数增多的独立危险因素;BMI、碘过量是TSH升高的独立危险因素;BMI、碘过量、维生素D缺乏、情志均是T_(3)、T_(4)升高的独立危险因素。结论年龄>65岁、BMI偏高、碘过量、硒缺乏、维生素D缺乏、情志抑郁焦虑等均可能导致患病风险增加,临床应及时关注并纠正HT患者的CD8^(+)T淋巴细胞及甲状腺各激素水平,充分评估,从而进行综合干预预防HT的发生。
Objective By analyzing the relationship between the levels of CD8^(+)T lymphocytes,thyroid-related hormones and the risk and prognosis of HT patients,the current study provides an objective knowledge basis for clinical selection.Methods A total of 112 HT patients who were hospitalized in the outpatient department of the Endocrinology Department of our hospital from December,2017 to March,2019 were selected as the research objects.According to the disease risk assessment,all patients were divided into the risk group(n=42)and safety group(n=70),and the correlation analysis of CD8^(+)T lymphocyte levels,thyroid-related hormone levels and clinicopathology in these patients was conducted.The unit Cox risk regression model was applied to analyze the relationship between various factors and prognosis of HT patients.Results Age,BMI,iodine excess,selenium deficiency,vitamin D deficiency,emotion,TSH,T_(3),T_(4) of the risk group were significantly higher than those of the safety group,and the number of CD8^(+)T lymphocytes was lower than that of the safety group(P<0.05).Survival curve analysis showed that HT patients with low levels of CD8^(+)T lymphocytes,and high levels of TSH,T_(3),T_(4) had a better survival rate(P<0.05).Using thyroid tissue CD8^(+)lymphocytes in HT patients,it was found that age,BMI,iodine excess,selenium deficiency,vitamin D deficiency,and emotions were independent risk factors for increased CD8^(+)lymphocyte count.BMI and iodine excess were independent risk factors for elevated TSH.BMI,iodine excess,vitamins D deficiency and emotion were independent risk factors for T_(3) and T_(4) elevation.Conclusion Age>65 years old,high BMI,excess iodine,selenium deficiency,vitamin D deficiency,emotional depression and anxiety,etc.may all lead to an increased risk of illness for HT patients.Clinicians should pay attention to and correct the CD8^(+)T lymphocytes and thyroid hormones in patients with HT timely and conduct full evaluation,so as to carry out comprehensive interventions to prevent the occurrence of HT.
作者
张敏
谢承均
ZHANG Min;XIE Chengjun(Department of Digestive Endocrinology,Sichuan Gem Flower Hospital,Chengdu 610210,China;Breast Nail Surgery, Sichuan Gem Flower Hospital, Chengdu 610210, China)
出处
《标记免疫分析与临床》
CAS
2022年第1期45-50,共6页
Labeled Immunoassays and Clinical Medicine
基金
四川省医学科研青年创新课题(编号:Q1501095)。
