慢性荨麻疹患者甲状腺自身抗体检出情况及其临床特征研究  

Detection of thyroid autoantibodies in patients with chronic urticaria and analysis of clinical features

作　　者：吴佳丽[1] 黄骏[2] 许爱娥[2] 

机构地区：[1]杭州市第三人民医院内分泌科,310009 [2]杭州市第三人民医院皮肤科,310009

出　　处：《中华皮肤科杂志》2017年第10期745-747,共3页Chinese Journal of Dermatology

基　　金：基金项目：国家自然科学基金（81271758、81472887）;卫生部科学研究基金一浙江省医药卫生重大科技计划（WKJ2012-2-036）;杭州市重大科技创新项目（20122513A02）

摘　　要：目的探讨伴有甲状腺自身抗体阳性的慢性荨麻疹患者临床与血清学特点。方法2016年1—12月，杭州市第三人民医院皮肤科70例慢性荨麻疹住院患者，依据是否伴有甲状腺自身抗体进行分组。对比两组患者的荨麻疹临床表现、自身皮肤血清试验结果、住院天数、出院转归、血常规、抗体、血清总IgE和IgG。结果70例慢性荨麻疹患者中有26例（37．1％）伴有甲状腺自身抗体阳性，44例（62．9％）甲状腺自身抗体阴性。甲状腺自身抗体阳性的慢性荨麻疹患者较甲状腺自身抗体阴性组风团更大，瘙痒更剧烈（z=4．399，P〈0．001）、持续时间更长（z=4．43，P〈0．001）、发作频率更高（z=7．362，P〈0．001）、更易伴发系统症状（x^2=7．068，P〈0．05）、自身皮肤血清试验阳性率更高（x^2=6．559，P〈0．05）、住院时间更长（t=3．184，P〈0．05）、出院时痊愈率更低（x^2=5．524，P〈0．05）、嗜碱性粒细胞数量更低（t=3．19，P〈0．05）。结论伴有甲状腺自身抗体阳性的慢性荨麻疹患者多表现为病情较重的荨麻疹，多伴有自身皮肤血清试验阳性和嗜碱性粒细胞水平降低。Objective To investigate clinical and serological characteristics of thyroid autoanti- body-positive patients with chronic urticaria. Methods A total of 70 inpatients with chronic urticaria were enrolled from the Department of Dermatology of Hangzhou Third Hospital between January and December in 2016, and divided into 2 groups according to the presence or absence of thyroid autoantibodies. Clinical manifestations, autologous serum skin test （ASST）results, hospital days, discharge outcome, routine blood test results, antibodies, and total serum IgE and IgG levels were compared between the 2 groups. Results Of 70 patients with chronic urticaria, 26 （37.1%）had positive thyroid autoantibodies, while 44 （62.9%）had negative thyroid autoantibodies. Compared with patients with negative thyroid autoantibodies, patients with positive thyroid autoantibodies showed significantly larger wheals and more severe itching （z = 4.399, P 〈 0.001 ）, longer duration （z = 4.43, P 〈 0.001 ） and higher frequency of clinical symptoms （z = 7.362, P 〈 0.001 ）, higher risk of being complicated by systemic symptoms （x^2 = 7.068, P 〈 0.05）, higher positive rates of ASST （x^2 = 6.559, P 〈 0.05）, longer hospital stay （t = 3.184, P 〈 0.05）, lower cure rate at discharge （x^2 = 5.524, P 〈 0.05） and less number of basophilic granulocytes （t = 3.19, P 〉 0.05）. Conclusion Chronic urticaria patients with positive thyroid autoantibodies show more severe urticarial condition, and are commonly complicated by positive ASST and decreased levels of basophilic zranulocvtes.

关 键 词：荨麻疹 甲状腺 自身抗体 自身免疫 嗜碱粒细胞 

分 类 号：R758.24[医药卫生—皮肤病学与性病学]