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1. 西南医科大学附属中医医院肾病内分泌科,泸州,646699
2. 西南医科大学附属第一医院核医学科,泸州,646000
3. 西南医科大学附属第一医院内分泌科,泸州,646000
纸质出版日期:2018,
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赵长英, 甘西伦, 王明霜, 等. 维生素D缺乏与Graves病及其并发症关系的临床研究[J]. 重庆医科大学学报, 2018,43(6):814.
Zhao Changying, Gan Xilun, Wang Mingshuang, et al. Clinical research on the deficiency of vitamin D with autoimmune thyroid disease[J]. Journal of Chongqing Medical University, 2018,43(6):814.
目的:研究弥漫性甲状腺肿伴甲亢(Graves disease,GD)、甲亢性眼病(Graves’ ophthalmopathy,GO)、甲亢性心脏病(hyperthyroid heart disease,HHD)患者血清25-(OH)D3水平与甲状腺功能、病程、甲状腺大小等的相关性。方法:选取符合试验标准的对象150例,分为:GD组(n=50),GO组(n=50),HHD组(n=50),同期与实验组匹配的50例体检正常者为正常对照组(n=50),检测所有对象的free triiodothyronine(FT3)、free thyroxine(FT4 )、thyroid stimulating hormone(TSH)、thyroid peroxidase antibody(TPOAb)、thyrotrophin receptor antibody(TRAb)及25-(OH)D3水平。血清25-(OH)D3水平参照国际标准:<20 ng/mL视为缺乏,20~30 ng/mL视为不足,≥30 ng/mL视为充足。结果使用SPSS 17.0统计软件进行分析。结果:①与正常组相比,GD组、GO组和HHD组血清 FT3、FT4、TPOAb、TRAb均明显升高(P=0.000),TSH、25-(OH)D3均明显降低(P=0.000);GD组、GO组和HHD组血清 FT3、FT4、TPOAb、TRAb和TSH差异均无统计学意义(P>0.05);血清25-(OH)D3水平GO组和HHD组均明显低于GD组(P=0.000),而GO组和HHD组间差异(P=0.320)无统计学意义。②GO组25-(OH)D3水平与FT4(r=0.40,P=0.004)、FT3(r=0.39,P=0.006)呈显著正相关,与TSH未见统计学相关性(P>0.05);其余组未见统计学相关性(P>0.05)。结论:低25-(OH)D3血症可能与GD及相关并发症的出现密切相关,25-(OH)D3水平缺乏还可能参与了GO和HHD的发生和进展。
Objective:To study the correlation among serum 25-(OH)D3 level and thyroid function,thyroid disease duration,size in patients with Graves disease(GD) or Graves’ ophthalmopathy(GO) or hyperthyroid heart disease. Methods:Totally 150 cases of pa-tients diagnosed with the corresponding diagnosis were selected. All the cases were divided into GD group(n=50),GO group(n=50),HHD group(n=50),and the other 50 cases of healthy people at the same age were selected as the control group(n=50). Then all the cases were taken the morning fasting venous blood,in which the FT3 and FT4,TSH,TRAb,TPOAb,serum 25-(OH)D3 were tested. The study of 25-(OH)D3 level takes the rule of the international consensus for references:serum 25-(OH)D3 level< 20 ng/mL means vitamin D deficiency,and serum 25-(OH)D3 level 20-30 ng/mL means vitamin D is not enough,when the level ≥30 ng/mL suggests vitamin D is sufficient. All the data were analyzed by SPSS 17.0 statistical software
and the significant inspection standards is P<0.05. Results:①Compared with the control group,serum FT3,FT4,TPOAb,TRAb levels were significantly increased(P=0.000),and TSH,25-(OH)D3 levels were significantly decreased in GD group,GO group and HHD group(P=0.000). There was no significant difference in serum FT3,FT4,TPOAb,TRAb and TSH among GD group,GO group and HHD group(P>0.05). Serum 25-(OH)D3 level was sig-nificantly lower in GO group and HHD group than in GD group(P=0.000),and no statistical significant difference was ob-served between GO group and HHD group(P=0.320). ②The serum 25-(OH)D3 levels in group GO were significantly positively correlated with FT3(r=0.390,P=0.006) and FT4(r=0.40,P=0.004),but there was no statistically significant corre-lation with TSH(P>0.05). There was no statistical correlation between the remaining groups(P>0.05). Conclusion:The low level of 25-(OH)D3 maybe closely related with the pathogenesis of Graves disease and its complications,and the deficiency of serum 25-(OH)D3 may also be involved in the development and progression of GO and HHD.
弥漫性毒性甲状腺肿浸润性突眼甲亢性心脏病维生素D
Graves diseaseGraves’ ophthalmopathyhyperthyroid heart diseasevitamin D
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