儿童系统性红斑狼疮合并甲状腺功能异常临床分析  

A clinical study of thyroid dysfunction in children with juvenile systemic lupus erythematosus

作　　者：周怡芳[1] 李彩凤[1] 王江[1] 韩彤昕[1] 邝伟英[1] 邓江红[1] 张俊梅[1] 檀晓华[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《中国实用儿科杂志》2014年第8期620-623,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的研究儿童系统性红斑狼疮(JSLE)患者甲状腺功能异常发病情况及临床表现,探讨JSLE合并甲状腺功能异常与狼疮活动性及自身抗体的关系。方法 2010年1月至2013年8月首都医科大学附属北京儿童医院162例新发JSLE患者,检查其甲状腺功能,若异常则检测甲状腺球蛋白抗体(TG-Ab)、甲状腺微粒体抗体(TM-Ab)及甲状腺B超。统计学分析甲状腺功能异常与正常者的狼疮疾病活动性指数(SLEDAI)及抗核抗体(ANAs)滴度。结果 162例患者中61例甲状腺功能异常,其中4例为桥本甲状腺炎,57例仅T3减低,无明显临床症状。其中6例(9.8%)TG-Ab及TM-Ab阳性。甲状腺功能异常组SLEDAI显著高于与甲状腺功能正常组(P<0.05)。两组ANAs滴度差异无统计学意义(P>0.05)。结论 JSLE常合并甲状腺功能减低。甲状腺功能减低者狼疮活动性较甲状腺功能正常者高,需积极治疗。监测甲状腺功能及甲状腺抗体对JSLE患者非常重要。ObjectiveTo investigate the morbidity and clinical manifestation of thyroid dysfunction in juvenile system-ic lupus erythematosus（JSLE）individuals;to determine if there are correlations between thyroid dysfunction in JLSE in-dividuals and SLE activity as well as autoantibodies.MethodsThyroid function was examed in 162 JSLE children whowere identified between January 2010 to August 2013;TG-Ab,TM-Ab as well as thyroid B ultrasound were performedto the individuals with thyroid dysfunction. SLEDAI and ANAs titrate were compared between JSLE individuals with ab-normal thyroid function and those with normal thyroid function.ResultsTotally 61 of 162 JSLE children were foundwith abnormal thyroid function,4 of who were identified as Graves disease and 57 were only found subnormal T3.TG-Ab and TM-Ab was positive in some of the patients with abnormal thyroid function. There was a significant difference of SLEDAI between the children with normal thyroid function and those with abnormal thyroid function（P〈0.05）.There was no significant difference of ANAs titrate between the two group patients.ConclusionThe prevalence of sub-normal thyroid function is found higher in JSLE children than in normal individuals,and most of them are identified withdecreased T3 without significant clinical features,and the others are identified as Graves disease. It is also found thatSLEDAI is higher in individuals with subnormal thyroid function compared to these with normal thyroid functions,andmore attention and active therapy are required. It is very important to monitor TG-Ab,TM-Ab and thyroid function inJSLE children.

关 键 词：系统性红斑狼疮 儿童 甲状腺功能 狼疮疾病活动性指数 

分 类 号：R72[医药卫生—儿科]