本文關(guān)鍵詞： 甲狀腺激素 促甲狀腺激素 甲狀腺毒癥 甲狀腺功能減退癥 貧血　出處：《南方醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究主要研究甲狀腺疾病與貧血的相關(guān)性,分析甲狀腺激素與紅細胞相關(guān)指標的相關(guān)性及其對貧血的影響,為臨床貧血查因及甲狀腺疾病的診療提供實驗依據(jù)。方法:本研究為回顧性分析,收集了 2012-01-01至2016-12-31初次在南方醫(yī)科大學(xué)珠江醫(yī)院就診時,同一天檢測了甲狀腺功能(FT3、FT4、TSH)和血常規(guī)的患者的數(shù)據(jù)(剔除同一患者反復(fù)檢測的數(shù)據(jù)),只保留甲狀腺相關(guān)疾病的數(shù)據(jù),剔除其他疾病的數(shù)據(jù)。按年齡將數(shù)據(jù)分成2組,14歲以上納入總數(shù)據(jù)組,14歲及以下納入兒童組,因兒童組數(shù)據(jù)不足,此次不納入統(tǒng)計;14歲以上共收集14580例。根據(jù)實驗室檢查數(shù)據(jù)將樣本分為甲狀腺毒癥組、亞臨床甲亢組、甲減組、亞臨床甲減組和正常組。將TSH進行對數(shù)轉(zhuǎn)換后,各組檢測指標用均數(shù)、標準差(X±S)進行描述,組間比較采用單因素方差分析。對甲狀腺功能不同組貧血的患病率是否存在組間差異進行卡方檢驗。對甲狀腺相關(guān)指標與紅細胞相關(guān)指標之間是否存在相關(guān)性采用Pearson相關(guān)分析。以上統(tǒng)計均采用IBM SPSS 20.0版進行統(tǒng)計,P0.05時認為差異有統(tǒng)計學(xué)意義。結(jié)果:①14歲以上人群中,甲狀腺毒癥組和亞臨床甲亢組的Hb、MCV、MCH均低于正常組,RDW高于正常組,而RBC和MCHC與正常組無顯著性差異。甲減組的RBC、Hb、MCH低于正常組,RDW高于正常組,而MCV、MCHC與正常組無顯著性差異;亞臨床甲減組的RBC、Hb低于正常組,MCV、MCH、MCHC、RDW與正常組無顯著性差異。②甲狀腺毒癥組、亞臨床甲減組和正常組女性貧血的患病率均高于男性,而亞臨床甲亢組和甲減組不同性別貧血的患病率無顯著性差異。③甲狀腺毒癥組貧血的患病率隨年齡增加有上升趨勢,正常組貧血的患病率與年齡有關(guān),但無明顯線性趨勢;亞臨床甲亢組、甲減組和亞臨床甲減組貧血的患病率與年齡無顯著性相關(guān)。④甲狀腺毒癥組和亞臨床甲亢組貧血的患病率均高于正常組,而甲狀腺毒癥組與亞臨床甲亢組貧血的患病率無顯著性差異。甲減組貧血的患病率高于亞臨床甲減組,且甲減組和亞臨床甲減組貧血的患病率均高于正常組。⑤甲狀腺毒癥組和甲減組貧血類型與正常組不同,亞臨床甲亢組和亞臨床甲減組貧血類型與正常組無顯著性差異。甲狀腺毒癥組和甲減組小細胞低色素性貧血和正常細胞性貧血的患病率高于正常組,且正常細胞性貧血的患病率比小細胞低色素性貧血的患病率升高的更明顯。甲功異常組與正常組貧血的程度無顯著性差異。⑥0≤TSH0.35mIU/L或TSH10.0 mIU/L時貧血的患病率比0.35 mIU/L≤TSH ≤ 5.5 mU/L(參考區(qū)間)時高,而 5.5mIU/LTSH≤10mIU/L 時貧血的患病率與 0.35mIU/L≤TSH≤5.5 mU/L無顯著性差異。⑦FT3、FT4與RBC始終呈正相關(guān),TSH與RBC始終呈負相關(guān);甲狀腺毒癥和亞臨床甲亢時,FT3、FT4與Hb呈負相關(guān);甲狀腺功能正常、甲減和亞臨床甲減時FT3、FT4與Hb呈正相關(guān);甲減和亞臨床甲減時TSH與Hb呈負相關(guān),甲狀腺毒癥、亞臨床甲亢和甲狀腺功能正常時,TSH與Hb無顯著性相關(guān)。結(jié)論:14歲以上人群中,FT3、FT4促進RBC生成,TSH抑制RBC生成;甲狀腺毒癥、亞臨床甲減、甲減、亞臨床甲減時均抑制Hb的合成。甲狀腺疾病患者貧血的患病率升高,二者常并存,對于臨床貧血查因及貧血的對癥治療無效的患者,應(yīng)考慮甲狀腺疾病的可能性。而對于甲狀腺疾病患者,也應(yīng)注意是否有合并貧血,是否需要同時糾正貧血。
[Abstract]:Objective: This study focuses on the correlation between thyroid disease and anemia, correlation analysis of thyroid hormone related to red blood cells and its effect on anemia, to provide the experimental basis for the diagnosis and treatment of acute anemia and thyroid disease. Methods: This study is a retrospective analysis, collection of 2012-01-01 to 2016-12-31 for the first time in Zhujiang Hospital of Southern Medical University. Detection of thyroid function the same day (FT3, FT4, TSH) and blood routine data of patients (excluding the same patients with repeated testing data), retaining only the thyroid related diseases, other diseases excluding data. Data will be divided into 2 groups according to age, over the age of 14 is included in the data set, and at the age of 14 the following into the group of children, because children are not included in the set of data, statistics over the age of 14; 14580 cases were collected. According to the laboratory examination data were divided into subclinical thyrotoxicosis group. The bed hyperthyroidism group, hypothyroidism group, subclinical hypothyroidism group and normal group. TSH after logarithmic transformation was used for each test index, standard deviation (X + S) are described. The comparison between groups using single factor analysis of variance on thyroid function in different groups. The prevalence of anemia whether there are differences between groups of cards whether there is square test. Pearson correlation analysis was performed between the thyroid related index and red blood cell index. The above statistics are using IBM SPSS version 20 statistics, P0.05 o.05indicatedstatisticaldifference. Results: 14 year olds in the thyroid gland, sepsis group and subclinical hyperthyroidism group Hb, MCV MCH, were lower than the normal group, RDW higher than the normal group, while RBC and MCHC had no significant difference with the normal group. The hypothyroidism group RBC, Hb, MCH lower than the normal group, RDW higher than the normal group, while MCV and MCHC had no significant difference with normal group; subclinical hypothyroidism group RBC, Hb Compared with the normal group, MCV, MCH, MCHC, RDW had no significant difference with the normal group. The thyrotoxicosis group, the prevalence rate of subclinical hypothyroidism group and normal group of anemia were higher than males, and subclinical hyperthyroidism group and hypothyroidism group different sex anemia prevalence rate had no significant difference between the thyroid gland. The prevalence of anemia in sepsis group with age increase with the normal group, the prevalence of anemia was associated with age, but no obvious linear trend; subclinical hyperthyroidism group and hypothyroidism group and subclinical hypothyroidism group the anemia prevalence rate and age had no significant correlation. The thyrotoxicosis group and the prevalence rate of subclinical hyperthyroidism the anemia group were higher than the normal group, and thyrotoxicosis group and subclinical hyperthyroidism group the prevalence of anemia. No significant difference in the prevalence of anemia is higher than that of hypothyroidism and subclinical hypothyroidism group, hypothyroidism group and subclinical hypothyroidism group the anemia prevalence rate is higher than the normal group 5. Thyrotoxicosis group and hypothyroidism group and normal group in different types of anemia, anemia group, subclinical hyperthyroidism and subclinical hypothyroidism group type had no significant difference with the normal group. The prevalence rate of thyrotoxicosis group and hypothyroidism group microcytic anemia and normal cell anemia is higher than the normal group, and normal cells the prevalence of anemia than microcytic hypochromic anemia prevalence rate increased significantly. There was no significant difference in thyroid dysfunction anemia group and normal group. The degree of anemia in 0 TSH0.35mIU/L or TSH10.0 mIU/L prevalence ratio 0.35 mIU/L 5.5 = TSH = mU/L (reference interval) high, and anemia 5.5mIU/LTSH the prevalence rate of less than 10mIU/L and 0.35mIU/L = TSH = 5.5. There was no significant difference in mU/L, FT3, FT4 and RBC always positively related to TSH and RBC were negatively correlated; thyrotoxicosis and subclinical hyperthyroidism, FT3, FT4 was negatively correlated with Hb; a The thyroid function was normal, hypothyroidism and subclinical hypothyroidism at FT3, FT4 was positively associated with Hb; hypothyroidism and subclinical hypothyroidism TSH negatively correlated with Hb, thyrotoxicosis, subclinical hyperthyroidism and normal thyroid function, no significant correlation between TSH and Hb. Conclusion: people over the age of 14, FT3, FT4 promote the formation of RBC, TSH inhibited RBC formation; thyrotoxicosis, subclinical hypothyroidism, hypothyroidism, subclinical hypothyroidism during the synthesis of Hb were inhibited. The prevalence of anemia in patients with thyroid diseases increased, two often coexist, for the symptomatic treatment of acute anemia and ineffective clinical anemia patients, should consider the possibility of thyroid disease. In patients with thyroid disease, should also pay attention to whether the patients with anemia, and whether you need to correct anemia.

【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R581;R556

【參考文獻】

相關(guān)期刊論文 前4條

1 張堅力;;甲亢患者貧血有關(guān)指標檢測分析[J];中國誤診學(xué)雜志;2008年31期

2 周密,廖清奎,李豐益,李強,羅春華,高舉,賈蒼松,楊崇禮;甲狀腺激素T_3影響K562細胞轉(zhuǎn)鐵蛋白受體和鐵蛋白表達的分子機制研究[J];中華血液學(xué)雜志;2003年04期

3 高妍;Graves病診治中的幾個問題[J];中華內(nèi)分泌代謝雜志;2001年04期

4 楊燕;原發(fā)性甲狀腺功能減退癥26例誤診分析[J];河北醫(yī)學(xué);2001年05期

，

本文編號：1478351