桥本甲状腺炎患者外周血维生素D和单核细胞趋化蛋白1水平及其临床意义  

Changes of peripheral blood vitamin D and monocyte chemotactic protein 1 levels in patients with Hashimoto thyroiditis and their clinical significance

作　　者：孙丽华 石书龙 胡芳志 孙琳 Sun Lihua;Shi Shulong;Hu Fangzhi;Sun Lin(College of Clinical Medicine,Jining Medical University,Jining 272013,China;Department of Endocrinology,Jining First People's Hospital,Jining 272002,China)

机构地区：[1]济宁医学院临床医学院,济宁272013 [2]济宁市第一人民医院内分泌与代谢科,济宁272002

出　　处：《中国医师进修杂志》2024年第5期438-445,共8页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨桥本甲状腺炎(HT)患者外周血维生素D和单核细胞趋化蛋白1(MCP-1)的水平及其临床意义。方法采用前瞻性研究的方法,选取济宁市第一人民医院2022年10月至2023年4月桥本甲状腺炎患者100例。其中,甲状腺功能正常50例(HT甲状腺功能正常组),甲状腺功能减退50例(HT甲状腺功能减退组)。另外选取同期50例体检者为健康对照组。记录一般资料,检测游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)、维生素D和MCP-1水平。采用Pearson法或Spearman法进行相关性分析,二元Logistic回归分析导致HT发生的危险因素,受试者工作特征(ROC)曲线评估维生素D和MCP-1对HT的诊断价值。结果HT甲状腺功能减退组FT 3和FT 4明显低于健康对照组和HT甲状腺功能正常组[(3.48±1.00)pmol/L比(4.48±0.49)和(4.28±0.47)pmol/L、12.40(10.01,14.23)pmol/L比15.70(14.30,17.33)和15.00(13.10,16.00)pmol/L],TSH明显高于健康对照组和HT甲状腺功能正常组[8.60(5.56,27.13)mU/L比1.97(1.23,2.89)和3.06(2.34,3.42)mU/L],差异有统计学意义(P<0.01);健康对照组与HT甲状腺功能正常组FT 3、FT 4和TSH比较差异无统计学意义(P>0.05)。HT甲状腺功能正常组和HT甲状腺功能减退组TPOAb、TgAb和MCP-1明显高于健康对照组[367.90(151.60,547.30)和426.00(175.30,600.00)kU/L比9.00(9.00,9.30)kU/L、410.00(222.00,1218.00)和1061.00(427.30,1604.00)kU/L比13.20(12.08,15.03)kU/L、66.20(54.43,105.3)和79.47(41.57,114.1)ng/L比21.78(15.23,45.83)ng/L],维生素D明显低于健康对照组[14.32(11.24,16.99)和12.73(10.87,15.36)μg/L比18.12(15.49,21.92)μg/L],差异有统计学意义(P<0.01);HT甲状腺功能正常组与HT甲状腺功能减退组TPOAb、TgAb、MCP-1和维生素D比较差异无统计学意义(P>0.05)。健康对照组维生素D和MCP-1与FT 3、FT 4、TSH、TPOAb、TgAb无相关性(P>0.05)。HT甲状腺功能正常组维生素D与FTObjective To investigate the peripheral blood levels of vitamin D and monocyte chemotactic protein 1(MCP-1)in patients with Hashimoto thyroiditis(HT)and their clinical significance.Methods Adopting a prospective research approach,100 patients with HT from October 2022 to April 2023 in Jining First People′s Hospital were selected.Among them,the normal thyroid function was in 50 cases(HT normal thyroid function group),and the hypothyroidism was in 50 cases(HT hypothyroidism group).Another 50 cases of physical examination in the same period were selected as healthy control group.The general data were recorded.The levels of free triiodothyronine(FT 3),free thyroxine(FT 4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb),vitamin D and MCP-1 were measured.Correlation analysis was performed using Pearson method or Spearman method.Binary Logistic regression analysis was used to analyze the risk factors leading to the development of HT,and the receiver operating characteristic(ROC)was used to assess the diagnostic value of vitamin D and MCP-1 for HT.ResultsThe FT 3 and FT 4 in HT hypothyroidism group were significantly lower than those in healthy control group and HT normal thyroid function group:(3.48±1.00)pmol/L vs.(4.48±0.49)and(4.28±0.47)pmol/L,12.40(10.01,14.23)pmol/L vs.15.70(14.30,17.33)and 15.00(13.10,16.00)pmol/L,the TSH was significantly higher than that in healthy control group and HT normal thyroid function group:8.60(5.56,27.13)mU/L vs.1.97(1.23,2.89)and 3.06(2.34,3.42)mU/L,and there were statistical differences(P<0.01);there were no statistical differences in FT 3,FT 4 and TSH between healthy control group and HT normal thyroid function group(P>0.05).The TPOAb,TgAb and MCP-1 in HT normal thyroid function group and HT hypothyroidism group were significantly higher than those in healthy control group:367.90(151.60,547.30)and 426.00(175.30,600.00)kU/L vs.9.00(9.00,9.30)kU/L,410.00(222.00,1218.00)and 1061.00(427.30,1604.00)kU/L vs.13.20(12.08,15.03)kU/L,66.20(

关 键 词：甲状腺炎 甲状腺功能减退症 维生素D 单核细胞化学吸引蛋白质类 

分 类 号：R581.4[医药卫生—内分泌]