Graves眼病的活动性、严重程度与血清TRAb、血脂、脂蛋白水平的相关性研究  

Association study between the activity and severity of Graves’ ophthalmopathy and serum TRAb,blood lipid and lipoprotein levels

作　　者：周莹 程献[2] 高芸[1] 贾冰[1] 潘懿[1] 包建东[1] 陈侃[1] ZHOU Ying;CHENG Xian;GAO Yun;JIA Bing;PAN Yi;BAO Jiandong;CHEN Kan(Department of Endocrinology,Jiang Yuan Hospital Affliated to Jiangsu Institute of Nuclear Medicine,Wuxi,Jiangsu 214063,China;不详)

机构地区：[1]江苏省原子医学研究所附属江苏省江原医院,江苏无锡214063 [2]江苏省原子医学研究所

出　　处：《中国地方病防治》2023年第4期340-344,共5页Chinese Journal of Control of Endemic Diseases

基　　金：江苏省卫健委面上项目(M2021060);无锡市科技局项目(Y20212052)。

摘　　要：目的 探究Graves眼病(Graves’ ophthalmopathy,GO)的活动性、严重程度与血清TRAb、血脂、脂蛋白水平之间的相关性。方法 选取单纯性Graves病(Graves’ Disease,GD)的72例患者作为对照组,活动性GO患者66例、非活动性GO患者76例作为研究组。回顾性分析各组间患者的甲状腺功能、TRAb、血脂、脂蛋白、CAS评分、NOSPECS评级、EUGOGO分级的水平。采用相关性分析、线性回归、logistic分析TRAb、血脂谱与GO病情之间的关系。结果 (1)以单纯性GD组为对照组,非活动性GO组的胆固醇(TC)升高,活动性GO组的TC、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、脂蛋白a(Lp(a))均升高,活动性GO组的TC、TG、LDL-C、ApoA、ApoB、Lp(a)显著高于非活动性GO组(P<0.05)。(2)采用相关分析发现,TRAb与CAS评分、NOSPECS评级、EUGOGO分级呈正相关(P<0.05);TRAb与TC、ApoB呈正相关(P<0.05);CAS评分与TC、TG、LDL-C、ApoA1、ApoB、Lp(a)呈正相关。(3)采用线性回归分析发现,BMI、ApoB、TC是TRAb的影响因素。(4)采用logistic回归分析发现,CAS评分的影响因素是TRAb、TC、ApoB,EUGOGO分级的影响因素是TRAb、TG、Lp(a)。结论 TRAb滴度与GO病情的活动性、严重程度均相关,血清TC、ApoB对GO的活动性有影响,TG、Lp(a)对GO的严重程度有影响。因此,在GD和/或GO患者的治疗中,需要关注TRAb、血脂水平。Objective To explore the correlation between the activity of Graves' ophthalmopathy(GO) and the serum TRAb,blood lipid and lipoprotein levels.Methods A total of 72 patients with simple Graves' disease(GD) were selected as the control group,66 patients with active GO and 76 patients with inactive GO were selected as the study group.Thyroid function,TRAb,blood lipid,lipoprotein,CAS score,NOSPECS grade and EUGOGO classification of patients in each group were retrospectively analyzed.Correlation analysis,linear regression and logistic analysis were used to analyze the relationship between TRAb,lipid profile and GO.Results(1)Compared with the simple GD group,the cholesterol(TC) of the stable GO group was increased(P<0.05),while TC,triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A(ApoA),apolipoprotein B(ApoB) and lipoprotein a(Lp(a)) of the active GO group were increased(P<0.05).In addition,TC,TG,LDL-C,ApoA,ApoB and Lp(a) in the active GO group were significantly higher than those in stable GO group.(2)After adjusting for age,sex,course of hyperthyroidism and smoking history,TRAb was positively correlated with CAS score,NOSPECS grade,and EUGOGO classification(P<0.05);TRAb was positively correlated with TC and ApoB(P<0.05);CAS score was positively correlated with TC,TG,LDL-C,ApoA1,ApoB,Lp(a),and EUGOGO classification was positively correlated with TC,TG,LDL-C,ApoA1,ApoB,Lp(a)(P<0.05).(3)BMI,ApoB and TC were found to be the influencing factors of TRAb by linear regression analysis.(4)The influential factors for CAS score were TRAb,TC and ApoB by logistic regression analysis.The influential factors for EUGOGO grading were TRAb,TG and Lp(A) by logistic regression analysis.Conclusion The level of TRAb in GD and GO patients is correlated with the activity and severity of GO.Serum TC and ApoB have influence on the activity of GO.TG and Lp(a) affect the severity of eye disease.Therefore,attention should be paid to TRAb and lipid levels in the treatment of GD and/or GO patients.

关 键 词：GRAVES眼病 血脂 脂蛋白 

分 类 号：R771.3[医药卫生—眼科]