肝肾阴虚型类风湿关节炎合并桥本甲状腺炎与类风湿关节炎相关性研究  

Study on the Correlation Between Rheumatoid Arthritis of Liver-Kidney Yin Deficiency Type Combined with Hashimoto′s Thyroiditis and Rheumatoid Arthritis

作　　者：沈洲立 洪梦婕 陈盛[3] 李璇 沈杰 何东仪 唐小蓉 SHEN Zhouli;HONG Mengjie;CHEN Sheng;LI Xuan;SHEN Jie;HE Dongyi;TANG Xiaorong(Fangta Traditional Chinese Medicine Hospital of Songjiang District Shanghai,Shanghai,China,201800;Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,China,200005;Renji Hospital Affiliated to Shanghai Jiao Tong University,Shanghai,China,200001)

机构地区：[1]上海市松江区方塔中医医院,上海201800 [2]上海中医药大学附属光华医院,上海200005 [3]上海交通大学附属仁济医院,上海200001

出　　处：《河南中医》2025年第3期404-407,共4页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82074234)。

摘　　要：目的:观察肝肾阴虚型类风湿关节炎合并桥本甲状腺炎(Hashmoto′s thyroiditis,HT)与类风湿关节炎(rheumatoid arthritis,RA)的相关性。方法:选择2023年8月1日至2024年2月1日在上海市光华中西医结合医院收治的肝肾阴虚型类风湿关节炎患者51例,若患者甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)>34.0 IU·mL-1和/或甲状腺球蛋白抗体(thyroglobulin antibodies,TGAb)>115.00 IU·mL-1,则纳入类风湿关节炎合并桥本甲状腺炎(RA-HT)组,否则纳入类风湿关节炎(RA)组。选择健康受试者10例为正常组,比较RA-HT组和RA组一般资料、中医症状评分、健康评估问卷(health assessment questionnaire,HAQ)评分等,并检测三组外周血中辅助T细胞(peripheral helper T,Tph)比率。结果:RA-HT组与RA组患者年龄、病程、身体质量指数比较,差异无统计学意义(P>0.05);RA-HT组中医症状评分、HAQ评分、免疫球蛋白M(immunoglobulin M,IgM)、TPOAb、TGAb、肿瘤坏死因子-α(tumour necrosis factor-α,TNF-α)水平显著高于RA组,差异有统计学意义(P<0.05)。与RA组、正常组比较,RA-HT组Tph水平明显升高,差异有统计学意义(P<0.05)。结论:RA-HT患者体内炎症水平更高,Tph比率升高可能是RA患者甲状腺自身抗体阳性的原因之一。Objective:To observe the correlation between rheumatoid arthritis of liver-kidney yin deficiency type combined with Hashimoto′s thyroiditis and rheumatoid arthritis(RA).Methods:A total of 51 patients with RA of liver-kidney yin deficiency type admitted to Guanghua Hospital of Integrated Traditional Chinese and Western Medicine in Shanghai from August 1,2023 to February 1,2024 were selected.If the patients had thyroid peroxidase antibody(TPO-Ab)>34.0 IU·mL-1 and/or thyroglobulin antibodies(TGAb)>115.00 IU·mL-1,they were included in the RA combined with Hashimoto′s thyroiditis antibody positive(RA-HT)group;otherwise,they were included in the RA group.Ten healthy subjects were selected as the healthy control group.General data,TCM symptom score sheets,health assessment questionnaire(HAQ)scores,and the ratio of peripheral helper T cells(Tph)in peripheral blood of the RA-HT and RA groups were compared,and the ratio of Tph in peripheral blood of the three groups was detected.Results:There were no statistically significant differences in age,disease duration,and body mass index(BMI)between the RA-HT group and the RA group(P>0.05).The RA-HT group had significantly higher scores in TCM symptom assessment,HAQ,IgM,TPOAb,TGAb,and TNF-αlevels compared with the RA group,with statistically significant differences(P<0.05).Compared with the RA group and the normal group,the Tph level in the RA-HT group was significantly increased,with a statistically significant difference(P<0.05).Conclusion:The level of inflammation in the body of RA-HT patients is higher,and the increase in Tph ratio may be one of the reasons for the positive thyroid autoantibodies in RA patients.

关 键 词：类风湿关节炎 桥本甲状腺炎 肝肾阴虚证 外周辅助T细胞 

分 类 号：R274.984.3[医药卫生—中西医结合]