格雷夫斯病患者血浆β-内啡肽、降钙素基因相关肽和神经肽Y水平变化及其与甲状腺激素的相关性研究  

Change of β-EP,CGRP and NPY in plasma and relationship with thyroid hormone in patients with Graves's disease

作　　者：王攀[1] 刘松[1] 王霞[1] 蔡小佳[1] 王聚[1] 蒋智钢[2] 

机构地区：[1]遵义医学院附属医院核医学科,贵州遵义563003 [2]遵义医学院公共卫生学院,贵州遵义563003

出　　处：《中国现代医学杂志》2017年第5期38-41,共4页China Journal of Modern Medicine

基　　金：贵州省科学技术厅联合基金(No:黔科合LH字【2015】7470)

摘　　要：目的探讨格雷夫斯病(GD)患者血浆中β-内啡肽(β-EP)、降钙素基因相关肽(CGRP)和神经肽Y(NPY)水平变化的临床价值以及与甲状腺激素[游离三碘甲状腺原氨酸(FT_3)、游离甲状腺激素(FT_4)、促甲状腺激素(TSH)]之间的关系,为GD病寻找新的诊疗标志物。方法收集GD病患者90例,采用放射免疫分析法分别检测其治疗前、治疗后以及治愈后β-EP、CGRP、NPY和甲状腺相关激素水平,比较治疗前、后β-EP、CGRP及NPY水平的变化情况;采用回归方法分析三者与甲状腺激素之间的关系。结果治疗前、后的β-EP、CGRP及NPY水平变化明显,将治疗前、后与治愈后的数据之间进行两两比较,数据差异有统计学意义(P<0.05)。随着病程由治疗前、治疗后向治愈的转归,β-EP对FT_3的关系表现为先增强后减弱,对FT_4、TSH为先减弱后增强;CGRP对于FT_3、FT_4的相互关系表现为先增强后减弱,对TSH为先减弱后增强,NPY对于FT_3、FT_4的相互关系表现为先增强后减弱,对TSH表现为先减弱后增强的变化趋势;在病程中CGRP、TSH与GD病严重程度呈现负相关(r=-0.933和-0.944,P<0.05),而β-EP、NPY、FT_3及FT_4则与GD病严重程度表现为正相关(r=0.926,0.943及0.930,P<0.05)。结论β-EP、CGRP及NPY与GD疾病发展及其转归密切相关,有望成为新的诊断、疗效观察及预判治疗停药的参考指标。Objective To investigate the changes of β-EP, CGRP and NPY in plasma of patients with Graves＇s disease （GD） and their relationship with the changes of thyroid hormones during the course of GD. Methods The levels of β-EP, CGRP, NPY and related thyroid hormones in plasma in 90 GD patients were detected by radioimmunoassay before treatment, one year after treatment and healing respectively. The changes of levels of β-EP, CGRP and NPY were compared, furthermore, the relationship between them and thyroid hormones were analyzed by regression. Results There were significant differences （ P〈0.05） between different time points after compared levels of β-EP, CGRP and NPY. With the development of the disease, the impact extent of β-EP to FT3 increased at first and then decreased, and that to FT4, TSH were converse; the impact extent of CGRP to FT3 and FT4 increased at first and then decreased, but that toTSH was converse. The impact extent of NPY to FT3, FT4 showed increased at first and then decreased, and that to TSH was converse. CPRG and TSH were negatively correlated with the severity of GD disease （ s = -0.933 and -0.944, P〈0.05）, and β-EP, NPY, FT3, FT4 were positively correlated with that （ s=0.940, 0.926, 0.943 and 0.930, P〈0.05）. Conclusions β-EP, CGRP and NPY are closely related to the development and prognosis of GD. They are expected to become a new reference index for diagnosis, curative effect observation and discontinuation of GD disease.

关 键 词：格雷夫斯病 Β-内啡肽 降钙素基因相关肽 神经肽Y 相关性 

分 类 号：R581.1[医药卫生—内分泌]