原发性甲状腺功能减退对尿酸影响的临床观察  

Relationship between primary hypothyroidism and hyperuricemia: an investigation

作　　者：张荣荣[1] 李文超[1] 王哲[1] 李明龙[1] 

机构地区：[1]山东大学附属省立医院保健内分泌科,济南250021

出　　处：《军事医学》2013年第11期836-838,共3页Military Medical Sciences

基　　金：国家自然科学基金资助项目(81070625);山东省自然科学基金资助项目(ZR2009CM005)

摘　　要：目的研究原发性甲状腺功能减退(甲减)与尿酸的关系并探讨其可能的发生机制。方法测定36例甲减患者的甲状腺功能(FT3、FT4和TSH)、甲状腺自身抗体(Anti-TG、Anti-TPO和TRAb)、血尿酸(UA)、血脂、同型半胱氨酸(Hcy)、胱抑素(Cys)、β2微球蛋白(β2MG)以及24 h尿尿酸定量(24hUA),并与20例健康对照进行比较。甲减患者根据Anti-TG、Anti-TPO、TRAb存在与否分为桥本(HT)甲减(27例)和非HT甲减(9例)两个亚组,并行亚组间比较。结果与健康对照组比较,甲减组TSH、TC、TG、LDL-C、UA、Hcy、Cys和β2MG明显高于对照组,而FT3、FT4、HDL-C和24hUA显著低于对照组,均P<0.05;两亚组之间甲状腺功能及抗体、TC、LDL-C、UA和24hUA也有显著性差异。结论甲减患者更容易出现高尿酸血症,可能与甲状腺激素减少、脂代谢紊乱、高Hcy有关;HT甲减比非HT甲减UA水平更高提示自身免疫异常可能在高尿酸血症的发生中也发挥着重要作用。Objective To explore the relationship between primary hypothyroidism and hyperuricemia and to speculate their possible mechanism .Methods The levels of FT3 ,FT4 ,TSH, Anti-TG ,Anti-TPO, TRAb, UA, TC, TG, LDL-C, HDL-C,Hcy, Cys,β2 MG and 24hUA were measured in 36 patients with hypothyroidism , compared with 20 healthy sub-jects.According to the absence or presenceof Anti-TG, Anti-TPO and TRAb, the patients were divided into two sub-groups：the Hashimo to（HT） hypothyroidism group （27 cases） and the non-HT hypothyroidism group （9 cases）before they were compared with each other .Results Compared with healthy subjects , patients with hypothyroidism had higher TSH , TC,TG, LDL-C, UA, Hcy,Cys,andβ2MG,and lower FT3,FT4,HDL-C,and 24hUA.The difference was significant （P〈0.05）;the thyroid function, autoimmune antibodies, TC, LDL-C, UA and 24hUA were also significantly differen between the two sub-groups.Conclusion Patients with hypothyroidism are more prone to hyperuricemia , which may be related to decreased thyroid hormone , lipid metabolism disorder and hyperhomocysteine .The level of UA is higher in HT hypothyroidism than in non-HT hypothyroidism , indicating that autoimmune factors may be involved in the occurrence of hyperuricemia .

关 键 词：原发性甲状腺功能减退 高尿酸血症 

分 类 号：R581.2[医药卫生—内分泌]