桥本甲状腺炎患者肠道菌群分布特征及其与甲状腺功能的关系研究  

Study on Distribution Characteristics of Intestinal Flora and its Relationship with Thyroid Function in Patients with Hashimoto’s Thyroiditis

作　　者：佟瑞[1] 张薇 王剑 吴静 武文平[1] TONG Rui;ZHANG Wei;WANG Jian;WU Jing;WU Wenping(Department of Laboratory Medicine,Qinhuangdao Traditional Chinese Medicine Hospital,Hebei Qinhuangdao 066000,China;Department of Pathology,Qinhuangdao Traditional Chinese Medicine Hospital,Hebei Qinhuangdao 066000,China;Department of Physical Examination,Qinhuangdao Traditional Chinese Medicine Hospital,Hebei Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市中医医院检验科,河北秦皇岛066000 [2]秦皇岛市中医医院病理科,河北秦皇岛066000 [3]秦皇岛市中医医院体检科,河北秦皇岛066000

出　　处：《现代检验医学杂志》2024年第3期60-66,共7页Journal of Modern Laboratory Medicine

基　　金：秦皇岛市科学技术研究与发展计划(202301A130)。

摘　　要：目的通过分析桥本甲状腺炎(Hashimoto’s thyroiditis,HT)患者肠道菌群分布特征及肠道菌群变化与HT的相关性和对HT发生的预测价值,为临床HT诊疗提供参考。方法选取秦皇岛市中医医院2022年6月~2023年6月收治的120例HT患者纳入观察组,另选择该院同期30例健康体检者纳入对照组。两组均进行肠道菌群检测及甲状腺功能检测,对比两组及不同甲状腺功能HT患者的肠道菌群α多样性和门水平肠道菌群相对丰度,用Spearman相关性分析HT患者肠道菌群α多样性及门水平肠道菌群相对丰度与血清甲状腺球蛋白抗体(anti-thyroglobulin antibodies,TgAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibodies,TPOAb)水平及甲状腺功能的相关性;用受试者工作特征(Receiver operating characteristic,ROC)曲线分析肠道菌群α多样性及门水平肠道菌群相对丰度对HT的预测效能。结果与对照组比较,观察组的肠道菌群α香农多样性指数(Shannon-wiener diversity index,shannon)(4.66±0.61vs 5.21±0.46)和辛普森多样性指数(Simpson diversity index,simpson)(0.89±0.06 vs 0.93±0.07)均较低,差异有统计学意义(t=4.617,3.156,均P<0.05);观察组的拟杆菌门的相对丰度(52.31%±2.02%vs 58.59%±2.11%)较低,厚壁菌门(37.15%±2.43%vs 33.46%±2.56%)、变形菌门(3.36%±0.26%vs 2.79%±0.19%)、梭杆菌门(1.02%±0.09%vs 0.65%±0.11%)、放线菌门(1.01%±0.12%vs 0.57%±0.13%)和疣微菌门(0.82%±0.11%vs 0.41%±0.09%)的相对丰度均较高,差异具有统计学意义(t=15.096,7.360,11.267,19.231,17.665,18.882,均P<0.001);观察组的血清TgAb水平(169.12±10.23 IU/ml vs 18.59±1.78 IU/ml)和TPOAb水平(56.43±12.11 IU/ml vs 2.51±0.57IU/ml)均较高,差异具有统计学意义(t=80.097,24.319,均P<0.001)。该研究120例HT患者甲状腺功能正常者89例、异常者31例,与正常者比较,甲状腺功能异常者的肠道菌群α多样性指数shannon(4.49±0.64 vs 4.83±0.58),simpson(0.87±0.07 vs 0.91±0.05)较低,差异�Objective To explore the intestinal flora distribution characteristics in patients with Hashimoto’s thyroiditis(HT)and analyze the correlation between intestinal flora changes and HT and the predictive value on the occurrence of HT,so as to provide reference for clinical diagnosis and treatment of HT.Methods A total of 120 patients with HT admitted to Qinhuangdao Traditional Chinese Medicine Hospital from June 2022 to June 2023 were included in observation group,and 30 healthy physical examination subjects during the same period were enrolled as control group.Both groups performed intestinal flora detection and thyroid function detection.Theαdiversity and the relative abundance of intestinal flora at phylum level were compared between the two groups and among HT patients with different thyroid functions,and the correlation betweenαdiversity of intestinal flora and relative abundance of intestinal flora at phylum level,serum levels of anti-thyroglobulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)and thyroid function was analyzed by spearman correlation analysis.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency ofαdiversity and relative abundance of intestinal flora at phylum level on HT.Results Compared with control group,the intestinal floraαdiversity indexes of shannon-wiener diversity index(shannon)and simpson diversity index(simpson)were lower in observation group[4.66±0.61 vs 5.21±0.46,0.89±0.06 vs 0.93±0.07],and the differences were statistically significant(t=4.617,3.156,P<0.05).The relative abundance of Bacteroidetes in observation group was lower than that in control group(52.31%±2.02%vs 58.59%±2.11%),while the relative abundances of Firmicutes,Proteobacteria,Fusobacteria,Actinobacteria and Verrucomicrobia were higher than those in control group(37.15%±2.43%vs 33.46%±2.56%,3.36%±0.26%vs 2.79%±0.19%,1.02%±0.09%vs 0.65%±0.11%,1.01%±0.12%vs 0.57%±0.13%,0.82%±0.11%vs 0.41%±0.09%),and the differences were statistically significant(t=15.096,

关 键 词：桥本甲状腺炎 甲状腺功能 肠道菌群分布特征 

分 类 号：R581.4[医药卫生—内分泌] R446.5[医药卫生—内科学]