本文選題：自身免疫性甲狀腺疾病 + 羥-維生素D�。� 參考：《中國(guó)老年學(xué)雜志》2017年17期

【摘要】：目的探討25羥-維生素D[25(OH)D]水平、碘營(yíng)養(yǎng)狀況和自身免疫性甲狀腺疾病(AITD)的相關(guān)性。方法通過(guò)檢測(cè)380例粵中西部地區(qū)居民的空腹血清25(OH)D水平、甲狀腺功能、甲狀腺自身抗體、尿碘等相關(guān)指標(biāo)等,并比較25(OH)D缺乏患者治療后相關(guān)指標(biāo)的差異,分析血清25(OH)D、碘營(yíng)養(yǎng)狀況對(duì)AITD發(fā)病的影響。結(jié)果 Graves病(GD)組、橋本甲狀腺炎(HT)組25(OH)D3水平顯著低于健康對(duì)照組(P0.05)。GD組血清25(OH)D3水平與促甲狀腺激素受體抗體(TRAb)、游離三碘甲狀腺原氨酸(FT3)、游離甲狀腺素(FT4)呈顯著負(fù)相關(guān),與促甲狀腺激素(TSH)呈顯著正相關(guān)(P0.01,P0.05)。HT組血清25(OH)D3水平與抗甲狀腺球蛋白抗體(TGAb)、抗甲狀腺過(guò)氧化物酶抗體(TPOAb)、TSH呈顯著負(fù)相關(guān),與FT3、FT4呈顯著正相關(guān)(P0.01,P0.05)。在GD組應(yīng)用甲巰咪唑和HT組應(yīng)用左甲狀腺素的基礎(chǔ)上加用活性維生素D連續(xù)治療3個(gè)月后,GD組TRAb抗體水平明顯降低,HT組TGAb、TPOAb抗體水平也明顯降低(均P0.05)。GD組和HT組尿碘中位數(shù)均較對(duì)照組高。尿碘高的AITD患者25(OH)D3水平缺乏更明顯(P0.05)。結(jié)論 AITD初發(fā)患者伴低維生素D水平,其中尿碘高的AITD患者25(OH)D3水平缺乏更明顯。補(bǔ)充活性維生素D可降低其自身抗體水平。
[Abstract]:Objective to investigate the correlation between 25 hydroxyvitamin D [25(OH)D] level, iodine nutritional status and autoimmune thyroid disease (AITD). Methods the fasting serum 25(OH)D level, thyroid function, thyroid autoantibody, urinary iodine and other related indexes were measured in 380 residents of central and western Guangdong, and the difference of related indexes after treatment with 25(OH)D deficiency was compared. To analyze the effect of serum 25 OHD and iodine nutrition on the pathogenesis of AITD. Results the levels of serum 25(OH)D3 in Graves group and Hashimoto thyroiditis group were significantly lower than those in healthy control group (P 0.05). GD had a negative correlation with thyrotropin receptor antibody, free triiodothyronine FT3 and free thyroxine FT 4. There was a significant positive correlation between serum 25(OH)D3 level and anti-thyroglobulin antibody (25(OH)D3), anti-thyroid peroxidase antibody (TPO), and positive correlation with FT _ 3T _ 3T _ 4 (P _ (0.01) P _ (0.05) in the group of thyroid stimulating hormone (TSH) and thyroid stimulating hormone (TSH) (P _ (0.01) / P _ (0.05). The level of TRAb antibody in GD group was significantly lower than that in HT group (both P0.05).GD group and HT group) after three months of continuous treatment with active vitamin D on the basis of levathyroxine in GD group and HT group. The median iodine level was higher than that in the control group. The deficiency of 25(OH)D3 in AITD patients with high urinary iodine was more obvious (P 0.05). Conclusion the level of 25(OH)D3 in AITD patients with low vitamin D level is more obvious than that in AITD patients with high urinary iodine level. Supplementation of active vitamin D can reduce the level of autoantibodies.
【作者單位】： 南方醫(yī)科大學(xué)附屬小欖醫(yī)院急診科;
【基金】：中山市科技計(jì)劃項(xiàng)目(2014A1FC088)
【分類(lèi)號(hào)】：R581

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