视神经脊髓炎患者的甲状腺功能、抗体改变及并发自身免疫性甲状腺病的分析  

Retrospective study on thyroid function, the change of autoantibodies, and concurrent autoimmune thyroid disease in patients with neuromyelitis optica, and analysis of the clinical manifestation of NMO patients associated with autoimmune thyroid disease

作　　者：贾红娟[1,2] 叶静[1] 赵筱玲[1] 

机构地区：[1]首都医科大学宣武医院神经内科,100053 [2]黑龙江省大庆油田总医院神经内科

出　　处：《神经疾病与精神卫生》2012年第4期373-375,共3页Journal of Neuroscience and Mental Health

摘　　要：目的探讨37例视神经脊髓炎（NMO）患者甲状腺功能及自身抗体的改变，分析并发自身免疫性甲状腺病（AITD）的NMO患者的临床特点。方法回顾性分析2006～2011年首都医科大学宣武医院收治的37例视神经脊髓炎患者的甲状腺功能（TSH、T3、T4、FT3、FT4）和自身甲状腺抗体（TPOAb、TGAb），38名健康体检者作为对照组，比较2组研究对象的甲状腺功能和自身甲状腺抗体有无差异。同时比较并发AITD的NM0患者（5例）与无AIDT的NMO患者（32例）的临床特征、脊髓磁共振检查结果。结果（1）NMO组病人TSH、T3、FT3、T4和FT4与健康对照组之间差异无统计学意义；NMO组病人甲状腺自身抗体TPOAb、TGAb均高于健康对照组，两组之间差异有统计学意义（P值均〈0．05）。（2）5例（13．5％）并发AITD的NM0患者发病与第一次复发间隔的时间和第一次发作的EDSS评分，与无AITD的NM0患者之间的差异有统计学意义（P值均〈0．05），而两组病人病程持续时间、发作次数、第一年复发阳性率、脊髓MRI病变节段数之间的差异均无统计学意义。结论NMO患者的甲状腺功能正常，自身甲状腺抗体升高。并发AITD的NM0患者首次发作较轻，发病与首次复发间隔长，但不影响患者临床的总体病程。Objective To explore the change of thyroid function and autoantibodies in patients with neuromyelitis optica （NMO）, and to analyze the clinical manifestation of NMO associated with autoimmune thyroid disease （AITD）. Methods The thyroid function （TSH,T3,T4,FT3,FT4） and autoantibodies （TPOAb,TGAb） of 37 patients with NMO in XuanWu hospital during 2006 and 2011 were retrospectively reviewed. All 37 patients were compared with 38 health people in these two respects. Moreover, 5 patients associated with AITD were compared with 32 patients without AITD in clinical characteristic and the image of spinal MRI. Results （1） There was no significant difference on the TSH, T3, FT3, T4 and FT4 between the patients and the health control group. The NMO patients had higher levels of TPOAb （209. 97±387.91 U/ml） and TGAb （114.74±118.86 U/ml） than the health control group. （2） 5 （13.5%） NMO patients with AITD were all women. The time interval between the onset and the first recurrence was （35. 00±31.51）months. The EDSS score of the first attack was 1.50± 0.57, and showed significant difference between the NMO patients with AITD and those without it in these two aspects （P= 0. 045,P= 0. 033, respectively）. There was no significant difference in duration, frequency, relapse ratio, and the damage of spinal cord. Conclusions The thyroid function of NMO patients was normal, although there were increased thyroid antibodies. The time interval between onset and first relapse was longer and the severity of illness was minor in NMO patients associated AITD than those without AITD. However, all these difference would not affect the overall clinical course.

关 键 词：视神经脊髓炎 甲状腺功能 自身甲状腺抗体 自身免疫性甲状腺疾病 

分 类 号：R581[医药卫生—内分泌]