本文關(guān)鍵詞：甲狀腺自身免疫抗體異常與多發(fā)性硬化相關(guān)性的研究　出處：《昆明醫(yī)科大學》2016年碩士論文　論文類型：學位論文

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【摘要】：[目的]本文通過對多發(fā)性硬化患者的甲狀腺自身免疫抗體(ATA)、年齡、性別、病程、擴展殘疾狀況評分量表(EDSS)評分、治療效果等情況的研究,了解ATA異常與多發(fā)性硬化的相關(guān)性,并為多發(fā)性硬化的治療及預后的評估提供一定的參考。[方法]選取2014年1月至2016年1月于昆明醫(yī)科大學第一附屬醫(yī)院神經(jīng)內(nèi)科住院的符合2010年McDonald診斷標準診斷的64名多發(fā)性硬化患者作為實驗組。選取年齡及性別與實驗組相匹配的健康工作人員及患者家屬共74名作為對照組。采集入院時患者及正常對照組空腹靜脈血,采用化學發(fā)光法行甲狀腺功能檢測。1.首先對比實驗組與對照組中ATA陽性情況。2.其次,采集患者的一般情況、臨床資料、隨訪治療效果等,用二項式logistic回歸分析分析患者ATA陽性的影響因素。3.在將患者按ATA情況分為ATA陽性組及陰性組,分別對比患者的年齡、性別、TSH、EDSS評分、腦脊液、病變部位等情況,研究兩組間的差別。4.對比急性期及緩解期MS患者ATA異常的情況。采用SPSS17.0統(tǒng)計軟件進行統(tǒng)計分析。[結(jié)果]1.與正常對照組相比,MS患者組合并ATA陽性率高(p0.05)；2.患者性別、年齡及除ATA以外的甲功指標異常與患者ATA陽性相關(guān),女性患者更易合并ATA陽性,年齡越大越易合并ATA陽性,甲功其余指標異常者更易合并ATA陽性；3.ATA陽性組與ATA陰性組對比,ATA陽性者女性患者多見；ATA陽性者更大的可能性有TSH異常；ATA陽性患者殘疾較ATA陰性組重(P0.05)。ATA陽性及陰性組對比,年齡、治療后EDSS評分、腦脊液異常情況、有脊髓病變比例無統(tǒng)計學差異(P0.05)。4.MS患者急性期與緩解期對比,ATA陽性比例無統(tǒng)計學差異(p0.05)。[結(jié)論]多發(fā)性硬化患者合并甲狀腺自身免疫性抗體比例較正常人群高,ATA可能對MS的病程和預后有一定的影響。ATA的檢測越來越受到臨床的重視,建議MS患者常規(guī)行甲狀腺功能篩查,尤其是女性及年齡大者。對于β-干擾素、阿倫單抗等免疫調(diào)節(jié)治療的MS患者在治療期間應監(jiān)測ATA變化。
[Abstract]:[Objective] to study the ATAA, age, sex, course of disease, extended disability scale (EDSS) and therapeutic efficacy of thyroid autoimmune antibody (ATAA) in patients with multiple sclerosis (MS). To understand the correlation between ATA abnormality and multiple sclerosis, and to provide some reference for the treatment and prognosis of multiple sclerosis. [Methods] from January 2014 to January 2016, 64 patients with multiple sclerosis who were admitted to Department of Neurology, first affiliated Hospital of Kunming Medical University were selected and diagnosed according to 2010 McDonald diagnostic criteria. The patients were selected as experimental group. 74 health workers and family members matched by age and sex were selected as control group. Fasting venous blood was collected from patients and normal control group. The thyroid function was detected by chemiluminescence method. Firstly, the positive rate of ATA was compared between the experimental group and the control group. Secondly, the general situation, clinical data and follow-up treatment effect of the patients were collected. Binomial logistic regression analysis was used to analyze the influencing factors of ATA positive in patients. The patients were divided into ATA positive group and negative group according to ATA. The age and sex of the patients were compared. TSHN EDSS score, cerebrospinal fluid, lesion location and so on. To study the difference between the two groups. 4. To compare the abnormal ATA of MS patients in acute phase and remission stage. SPSS17.0 statistical software was used for statistical analysis. [Results 1.Compared with the normal control group, the positive rate of ATA in patients with MS was higher than that in the control group (P 0.05). 2. The abnormal gender, age and the index of thyroid function other than ATA were associated with the positive ATA in the patients. The female patients were more likely to be associated with ATA positive, and the older the patients were, the more likely the patients were to be associated with ATA positive. Those with abnormal thyroid function were more likely to be associated with ATA positive. 3. ATA-positive group and ATA negative group were more common in female patients with positive ATA-positive. ATA positive patients were more likely to have abnormal TSH. The disability of ATA positive patients was more severe than that of ATA negative group. The age, EDSS score and cerebrospinal fluid abnormality after treatment were significantly higher in ATA positive group than in ATA negative group. There was no statistical difference in the proportion of spinal cord lesions. 4. There was no significant difference in positive ratio of ATA-positive between acute phase and remission stage in patients with MS (P 0.05). [Conclusion: the ratio of thyroid autoimmune antibodies in multiple sclerosis patients with thyroid autoimmune antibodies is higher than that in normal controls. The detection of AATA may have a certain effect on the course and prognosis of MS. It is suggested that MS patients should be routinely screened for thyroid function, especially in women and older people. The changes of ATA should be monitored in MS patients treated with immunomodulatory therapy such as 尾 -interferon and alenumab.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R744.51

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