血浆纤维连接蛋白与^(131)I治疗格雷夫斯甲亢后早发甲状腺功能减退症的关系  

Relationship between plasma fibronectin and early hypothyroidism after ^(131)I treatment of Graveshyperthyroidism

作　　者：刘文涓 刘雄英 LIU Wenjuan;LIU Xiongying(Department of Nuclear Medicine,the First Affiliated Hospital/Clinical Medical School,Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院核医学科,广东广州510080

出　　处：《广东药科大学学报》2023年第4期101-105,共5页Journal of Guangdong Pharmaceutical University

摘　　要：目的探讨血浆纤维连接蛋白(fibronectin,FN)与^(131)I治疗格雷夫斯甲亢(Graveshyperthyroidism,GH)后早发甲状腺功能减退症的关系。方法收集2020年1月-2022年1月广东药科大学附属第一医院接收的^(131)I治疗后随访1年的214例GH患者的临床资料,其中甲减组140例,无甲减组74例,比较两组间性别、年龄、血浆FN、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibodies,TGAb)水平、^(131)I治疗剂量间的差异。选取有差异的因素纳入logistic回归进一步分析及进行两两成对比较。结果两组患者间性别、TPOAb、TGAb的分布差异无统计学意义(P>0.05);两组患者间的年龄、^(131)I治疗剂量和血浆FN差异均有统计学意义(P<0.05);logistic回归分析中只有^(131)I治疗剂量和血浆FN与最终预测结果相关(P<0.05),其OR值分别为0.896、1.005。两两比较中年龄为20~39岁组和40~59岁组间早发甲减发生率的差异有统计学意义(P<0.05);^(131)I治疗剂量为203.5~351.5 MBq组和370~555 MBq组间早发甲减发生率的差异有统计学意义(P<0.05)。结论血浆FN是新发现的早发甲减的独立影响因素,治疗前血浆FN浓度高的患者更容易发生早发甲减,可作为临床制定治疗方案的参考。Objective To investigate the relationship between plasma fibronectin(FN)and the early onset hypothyroidism after ^(131)I treatment of Graveshyperthyroidism(GH).Methods The clinical data of 214 patients with GH in the First Affiliated Hospital of Guangdong Pharmaceutical University from January 2020 to January 2022 who were followed up for 1 year after treatment of ^(131)I were collected.The data were divided into 140 patients in hypothyroid group and 74 patients in the group without hypothyroidism.The differences of gender,age,plasma FN,thyroid peroxidase antibody(TPOAb),thyroglobulin antibodies(TGAb)and therapeutic dose of ^(131)I were compared between the two groups.Factors with significant differences were selected for further logistic regression analysis and pairwise comparison.Results There were no significant differences in the distribution of gender,TPOAb and TGAb between the two groups(P>0.05).There were significant differences in age,^(131)I dose and plasma FN between the two groups(P<0.05).Logistic regression analysis showed that only ^(131)I treatment dose and plasma FN were associated with the final prediction(P<0.05),and their OR values were 0.896 and 1.005,respectively.The pair-to-pair comparison showed a statistically significant difference in the incidence of early hypothyroidism between the age group of 20-39 years and 40-59 years,and between the ^(131)I treatment dose of 203.5-351.5 MBq group and 370-555 MBq group(P<0.05).Conclusion Plasma FN is a newly discovered independent factor affecting early hypothyroidism.Patients with high plasma FN concentration before ^(131)I treatment are more likely to have early hypothyroidism,which can be used as a reference for clinicians to make treatment plans.

关 键 词：血浆纤维连接蛋白 格雷夫斯甲状腺功能亢进症 甲状腺功能减退症 ^(131)I治疗 

分 类 号：R582.1[医药卫生—内分泌]