基于真实世界的桥本甲状腺炎患者TPOAb滴度下降的影响因素分析  

Influencing factors of TPOAb titer decline in HT patients based on the real world

作　　者：杨泽佩 胡凯文[2] 李靖华 陈晓珩[3] 彰金[4] 商建伟[3] 李哲[3] 李会龙[3] 李璐[3] 户蕊 祁烁[5] 张涛静[1] 丁治国[5] YANG Zepei;HU Kaiwen;LI Jinghua;CHEN Xiaoheng;ZHANG Jin;SHANG Jianwei;LI Zhe;LI Huilong;LI Lu;HU Rui;QI Shuo;ZHANG Taojing;DING Zhiguo(Department of Endocrinology,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;Oncology Department,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078;Department of Thyroid Diseases,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Clinical Transformation and Interdisciplinary Innovation Laboratory of Thyroid Diseases Hospital,Sun Simiao Hospital,Beijing University of Chinese Medicine,Tongchuan 727100)

机构地区：[1]北京中医药大学东方医院内分泌病科,北京100078 [2]北京中医药大学东方医院肿瘤科,北京100078 [3]北京中医药大学东直门医院甲状腺病科,北京100700 [4]北京中医药大学东直门医院核医学科,北京100700 [5]北京中医药大学孙思邈医院甲状腺病院临床转化与交叉创新实验室,铜川727100

出　　处：《北京中医药》2025年第4期466-471,共6页Beijing Journal of Traditional Chinese Medicine

基　　金：国家人口健康科学数据中心中西医结合防治甲状腺疾病专题数据库建设项目(NCMI202406B01);陕西省卫生健康委员会陕西省卫生健康高层次人才(团队)培育计划项目(陕卫人函〔2024〕192号);陕西省中医药管理局中医药“双链融合”中青年科研创新团队项目(2022-SLRH-LG-005)。

摘　　要：目的基于真实世界研究分析桥本甲状腺炎(HT)患者TPOAb滴度下降的影响因素。方法纳入2018年6月―2021年9月于北京中医药大学东直门医院甲状腺病科就诊的1269例TPOAb阳性的HT患者为研究对象。收集研究对象的病历资料,采用单因素Logistics、多因素Logistics、LASSO回归分析,探讨HT患者TPOAb滴度明显下降优势人群与年龄、性别、甲状腺功能状态、中药服用时间等14项自变量之间的相关性。结果Logistics回归结果显示,抗体滴度明显下降优势人群的影响因素:与女性[OR=2.430,95%CI(1.403,4.463),P<0.05]、TRAb阳性[OR=1.676,95%CI(1.056,2.643),P<0.05]、中药中暴露[OR=1.795,95%CI(1.205,2.726),P<0.05]、中药高暴露[OR=3.839,95%CI(2.534,5.926),P<0.05]均呈正相关;与30~50岁[OR=0.648,95%CI(0.470,0.896),P<0.05]、>50岁[OR=0.343,95%CI(0.224,0.520),P<0.05]均呈负相关。同时LASSO结果显示,甲状腺功能状态可能是抗体滴度明显下降优势人群的影响因素(β=0.031)。结论HT患者TPOAb滴度明显下降优势人群的影响因素为性别、年龄、TRAb、甲状腺功能状态和中药服用时间。Objective To analyze,based on real-world data,the influencing factors associated with a significant decrease in TPOAb titers in patients with Hashimoto's thyroiditis(HT).Methods A total of 1269 TPOAb-positive HT patients were included.Medical records were collected,and univariate logistic regression,multivariate logistic regression,and LASSO regression analyses were conducted to explore the correlations between the dominant population with a significant decrease in TPOAb titers and 14 independent variables,including age,gender,thyroid function status,and duration of Chinese medicine use.Results Logistic regression analysis showed that the influencing factors for the dominant population with a significant decrease in antibody titers included female[OR=2.430,95%CI(1.403,4.463),P<0.05],TRAb positivity[OR=1.676,95%CI(1.056,2.643),P<0.05],moderate exposure to Chinese medicine[OR=1.795,95%CI(1.205,2.726),P<0.05],and high exposure to Chinese medicine[OR=3.839,95%CI(2.534,5.926),P<0.05],all showing positive correlations;age 30~50 years[OR=0.648,95%CI(0.470,0.896),P<0.05]and age>50 years[OR=0.343,95%CI(0.224,0.520),P<0.05],both showing negative correlations.Meanwhile,LASSO regression analysis indicated that thyroid function status(β=0.031)may also be an influencing factor for the dominant population with a significant decrease in antibody titers.Conclusion The influencing factors associated with a significant decrease in TPOAb titers in HT patients include gender,age,TRAb positivity,thyroid function status,and duration of Chinese medicine use.

关 键 词：甲状腺过氧化物酶抗体 桥本甲状腺炎 清肝健脾法 影响因素 真实世界 

分 类 号：R581[医药卫生—内分泌]