高原红细胞增多症患者甲状腺功能改变及其影响因素分析  

Analysis of Thyroid Function Changes and Influencing Factors in Patients with High Altitude Polycythemia

作　　者：米娜[1] 李永桂 余青原 蒋冬梅[1] 王勃[1] 杨历新[1] 何婷 MI Na;LI Yonggui;YU Qingyuan;JIANG Dongmei;WANG Bo;YANG Lixin;HE Ting(The People's Hospital of Qinghai,810007)

机构地区：[1]青海省人民医院,810007

出　　处：《高原医学杂志》2023年第4期18-22,共5页Journal of High Altitude Medicine

基　　金：青海省卫生健康委员会指导性课题(2021wjzdx-21)。

摘　　要：目的:观察青海地区高原红细胞增多症(HAPC)患者甲状腺功能,了解影响HAPC患者甲状腺功能的因素。方法:选择404例明确诊断为HAPC患者,观察其甲状腺功能及甲状腺疾病检出率,分析HAPC患者甲状腺功能的影响因素。结果:(1)青海地区中海拔、高海拔、超高海拔地区HAPC患者促甲状腺激素(TSH)水平分别为(2.52±1.76)mIU/L、(2.88±1.63)mIU/L、(2.97±1.75)mIU/L,不同海拔HAPC患者TSH水平比较,差异有统计学意义(P<0.05);中海拔、高海拔、超高海拔地区HAPC患者HGB水平分别为(213.4±12.4)g/L、(214.8±12.3)g/L、(217.8±12.7)g/L,不同海拔HAPC患者HGB水平比较,差异有统计学意义(P<0.05);(2)不同性别、民族、年龄的HAPC患者TSH水平比较,差异无统计学意义(P>0.05);(3)男性、女性HAPC患者甲状腺疾病检出率分别为7.7%、15.4%,二者之间差异有统计学意义(P<0.05);男性、女性HAPC患者甲减及亚甲减检出率分别为6.3%、13.2%,二者之间差异有统计学意义(P<0.05);中海拔、高海拔、超高海拔地区HAPC患者甲减及亚甲减检出率分别为5.1%、8.0%、15.5%,三者之间差异有统计学意义(P<0.05);(4)女性HAPC患者检出甲减及亚甲减的风险是男性的2.799倍,超高海拔HAPC患者甲减及亚甲减检出率是中海拔的3.587倍。结论:海拔越高,HAPC患者TSH水平越高;海拔越高,HAPC患者甲减及亚甲减检出率越高;性别、海拔是影响HAPC患者甲状腺功能的危险因素。Objective:This study is aimed to observe the thyroid function in patients with highaltitude polycythemia(HAPC)and to understand the factors affecting thyroid function in H APC patients.Methods:404 patients with HAPC were selected,whose thyroid function and the detection rate of thyroid diseases were observed.The influencing factors of thyroid function were analyzed in patients with HAPC.Results:(1)The TSH levels of HAPC patients at moderate altitude,high altitude,and ultra-high altitude in Qinghai were(2.52±1.76)mIU/L,(2.88±1.63)mIU/L,and(2.97±1.75)mIU/L,respectively,and there were significant differences between the TSH levels of HAPC patients at different altitudes(P<0.05).HGB levels in patients with moderate altitude,high altitude and ultra-high sea areas were(213.4±12.4)g/L,(214.8±12.3)g/L,(217.8±12.7)g/L,respectively,and HGB levels in patients with different elevations(P<0.05);(2)There was no difference in TSH level among HAPC patients of different genders,ethnicities,and ages.(3)The incidence rates of thyroid diseases in male and female HAPC patients were 7.8%and 15.5%,respectively,and there was a difference between them(P<0.05).The incidence rates of hypothyroidism and subclinical hypothyroidism in male and female HAPC patients were 6.3%and 13.2%,respectively,and there was a difference between them(P<0.05).The incidence rates of hypothyroidism and subclinical hypothyroidism in patients from moderate altitude,high altitude,and ultra-high altitude areas were 5.1%,8.0%,and 15.5%,respectively,and there was a difference among them(P<0.05).(4)The risk of hypothyroidism and subclinical hypothyroidism detected in female HAPC patients was 2.799 times higher than that of male patients and the detection rate of hypothyroidism and subclinical hypothyroidism in ultra-high altitude HAPC patients was 3.587 times compared with that of moderate altitude patients.Conclusion:The higher the altitude is,the higher the TSH level in HAPC patients will be;.and the higher the altitude is,,the higher the detection rate of thy

关 键 词：高原红细胞增多症 促甲状腺激素 海拔 甲状腺功能 

分 类 号：R581[医药卫生—内分泌] R555.1[医药卫生—内科学]