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1.
目的:检测初诊桥本氏甲状腺炎(Hashimoto’s thyroiditis,HT)患者外周血CD4+ CD45RO+ 记忆性T 细胞比例,探讨其在HT 发病中的意义。方法:收集初诊的HT 患者作为病例组(HT,n =53),另外选取年龄、性别相匹配的正常人作为对照组(HC,n =43),并根据甲状腺功能状态将HT 组分为甲状腺功能正常组(HT-A,n =15)、亚临床甲减组(HT-B,n =14)和临床甲减组(HT-C,n =24)。流式细胞仪检测外周静脉血中CD4+ CD45RO+记忆性T 细胞比例,酶联免疫吸附法检测血清中IFN 、IL-17 水平,化学发光法检测甲状腺功能及甲状腺特异性抗体滴度。结果:HT 组外周血中CD4+ CD45RO+ 记忆性T 细胞比例、IFN 、IL-17、TPOAb 与TgAb 水平均显著高于HC 组,P<0.01。双变量相关分析显示HT 患者外周血CD4+ CD45RO+记忆性T 细胞的比例与IFN 、TPOAb、TgAb 均呈正相关(P<0.01,P =0.015,P<0.01)。结论:CD4+ CD45RO+ 记忆性T 细胞在HT 患者外周血中呈高表达,CD4+ CD45RO+记忆性T 细胞可能参与了HT 的发病过程。  相似文献   

2.
目的:研究弹性成像应变率比值(SR)、最大血流速度、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)应用于桥本氏甲状腺炎的临床诊断.方法:选取我院收治的86例桥本氏甲状腺炎患者作为实验组,根据甲状腺功能分为甲亢组(n=32)、甲减组(n=25)以及单纯甲状腺肿组(n=29).并选取同期86例健康体检者作为对照组(n=86).所有入选者均接受弹性成像超声和血清学检查.对比实验组和健康组弹性成像超声指数和TPOAb、TgAb及促甲状腺激素(TSH)水平;对比不同甲状腺功能患者的SR值、最大血流速度和TPOAb、TgAb水平、TSH;分析SR值、最大血流速度和TPOAb、TgAb与TSH的相关性.结果:与对照组相比,实验组SR值显著降低,最大血流速度、TPOAb、TgAb和TSH显著增高(P<0.05).与单纯甲状腺肿组相比,甲亢组SR值和TSH水平显著更低,最大血流速度、TPOAb、TgAb和TSH显著更高,甲减组SR值显著更低,最大血流速度、TPOAb、TgAb和TSH显著更高(P<0.05);与甲减组相比,甲亢组患者SR值和TSH水平显著更低,最大血流速度、TPOAb、TgAb和TSH显著更高(P<0.05).结论:桥本氏甲状腺炎患者的SR值、最大血流速度TPOAb以及TgAb均存在明显的变化.患者在不同甲状腺功能中也存差异性,临床上可将SR值、最大血流速度TPOAb以及TgAb作为桥本氏甲状腺炎诊断的辅助方法.  相似文献   

3.
目的:探讨桥本甲状腺炎(HT)超声弹性评分和弹性系数与甲状腺自身免疫功能的相关性。方法:216 例桥本甲状腺炎患者,采用GE LOGIQ3 型彩色多普勒超声诊断仪获得满意弹性图像后,评定弹性评分及弹性系数;化学发光法检测甲状腺功能及甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb) 滴度,分别分析甲状腺超声弹性评分和弹性系数与甲状腺自身抗体相关性。结果:216 例HT 患者血清促甲状腺激素(TSH)、TGA、TPO 明显升高,TgAb 的滴度与弹性系数呈正相关,r=0.54 ,P<0.01;TgAb 与弹性评分呈正相关,r =0.496,P<0.01;TPOAb 与弹性应变系数呈正相关,r =0.77,P<0.01,TPOAb 与弹性评分呈正相关,r =0.73,P<0.01。结论:实时超声弹性成像评分结合甲状腺自身免疫功能检测,有助于提高桥本甲状腺炎诊断的正确性。  相似文献   

4.
目的:测定不同性别和年龄健康成年人足趾皮肤温度和加热前后微血管血流灌注量的变化。方法:选择51例健康成年人(31~83岁)。分别按性别不同分为:男性组(n=25),女性组(n=26),以及按年龄不同分为:31~40岁组(n=11)、41~50岁组(n=9)、51~60岁组(n=6)、61~70岁组(n=10)、≥71岁组(n=15)后,用激光多普勒血流仪(LDF)检测各组左足趾皮肤温度、基础血流灌注量(PU0)、加热至44℃时的血流灌注量(PU)以及加热后血流灌注量与基础血流灌注量的比值(加热后比值),比较不同性别组和年龄组上述指标测定值的差异,分析年龄与加热前后血流灌注量的相关性。结果:(1)不同性别的足趾皮肤温度、PU0、PU、加热后比值均无显著性差异(P>0.05),但PU明显高于PU0(P<0.01)。(2)不同年龄组足趾皮肤温度、PU0及PU的比较均无显著性差异(P>0.05);不同年龄组之间加热后比值随年龄增长呈下降趋势。统计学分析结果显示:61~70岁组以及≥71岁组加热后比值明显低于31~40岁组(P<0.01);≥71岁组加热后比值明显低于41~50岁组(P<0.05)。(3)年龄与足趾皮肤温度、PU0及PU之间均无显著相关性(P>0.05);年龄与加热后比值呈负相关(r=-0.419,P<0.05)。结论:不同性别健康成年人足趾皮肤温度和血流灌注量无明显差异,随着年龄增加,足趾皮肤微血管反应性明显降低,血流储备能力下降。  相似文献   

5.
目的:探讨沧州市健康体检人群甲状腺自身抗体的阳性率及其与甲状腺功能异常的相关性。方法:采用电化学发光免疫分析技术测定沧州市3 218 名健康体检人群血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb),分别以TPOAb>34 U/ ml 和TgAb>115 U/ ml 为阳性,对检测结果进行统计分析。结果:健康人群甲状腺自身抗体的总阳性率为16.19%,且随年份增加呈明显的增高趋势,不同性别之间的阳性检出率有显著性差异(P <0.001),其中TPOAb、TgAb、TPOAb 和TgAb 同时阳性的检出率分别为14.57%、12.74%和11.12%,1 686 名女性的阳性检出率(21.53%、19.16%、16.67%)显著高于男性(6.92%、5.68%、5.03%),差异有统计学意义(P 均<0.001),且随年龄增加阳性检出率逐渐升高,女性阳性率高峰在逸70 岁年龄组,男性阳性率高峰在50 ~59岁年龄组。甲亢和亚甲亢、甲减和亚甲减甲状腺自身抗体的阳性检出率和OR 均有显著性差异(P<0.001)。结论:沧州市健康体检人群甲状腺自身抗体的阳性率较高,对甲状腺功能正常而自身抗体阳性者进行动态监测、随访或早期干预,有利于甲状腺疾病的早期诊断、鉴别诊断及其防治。  相似文献   

6.
目的了解心理咨询门诊来访者EPQ的评分情况。方法对107例心理咨询来访者进行EPQ测试,按《修订艾森克个性问卷手册》规定的标准分进行分组,以SPSS17.0进行统计分析。结果①男性来访者的N分显著高于全国常模(t=7.818,P<0.001),女性来访者的N分显著高于全国常模(t=7.902,P<0.001);②男性20~(岁)组E分显著低于全国常模(t=3.098,P<0.01)、男性50~(岁)组E分显著低于全国常模(t=8.073,P<0.05),女性50~(岁)组E分显著高于全国常模(t=2.490,P<0.05);③男性20~(岁)组、30~(岁)组、40~(岁)组的N分显著高于全国常模(t=3.306,4.652,7.581;P<0.01),女性16~(岁)组、20~(岁)组、30~(岁)组、40~(岁)组的N分显著高于全国常模(t=18.567,3.334,7.665,4.229;P<0.01);④男性20~(岁)组的P分显著高于全国常模(t=2.145,P<0.05),女性20~(岁)组的P分显著高于全国常模(t=3.165,P<0.01),女性50~(岁)组的P分显著低于全国常模(t=7.085,P<0.001);⑤男性职业是工人及自由职业者的N分显著高于全国常模(t=5.351,5.476;P<0.001);女性职业是工人、职员、自由职业者的N分显著高于全国常模(t=5.552,P<0.001;t=4.038,P<0.01;t=5.181,P<0.001);⑥男性患焦虑症的E分显著低于全国常模(t=3.969,P<0.01),女性患精神障碍的E分显著低于全国常模(t=2.524,P<0.05);男性患抑郁症、焦虑症、精神障碍的N分显著高于全国常模(t=4.112,P<0.01;t=4.800,P<0.001;t=3.254,P<0.05)。女性患抑郁症、其他疾病的N分显著高于全国常模(t=8.306,P<0.001;t=6.571,P<0.01);⑦107例来访者中,有典型内向及内向倾向者占30.8%,典型外向及外向倾向者占25.3%,典型情绪不稳及情绪不稳倾向占65.4%,典型精神质占15.9%;⑧在内、外向情绪不稳43例中,内向不稳占65.1%。内向不稳组中,20~(岁)组、30~(岁)组共占82.1%,诊断是抑郁症、焦虑症者占71.4%。结论 EPQ量表较好地反映了来访者的个性,根据EPQ的具体结果,可帮助心理咨询师有针对性地对来访者进行心理咨询。  相似文献   

7.
目的:分析湖北地区人乳头瘤病毒(HPV)感染状况及基因型分布。方法:2012-03-2015-11在本院体检、门诊或住院9 058例女性宫颈脱落细胞,采用流式点阵仪/液态芯片分析系统检测其HPV基因分型,分析所有受检者HPV基因型分布及单一、多重感染分布,比较不同年龄、不同就诊途径及不同疾病组间HPV感染特点。结果:所有受检者中共检出HPV阳性2 524例,感染率27.86%。湖北地区最常见的四种HPV亚型为HPV16(7.37%)、52(5.05%)、58(4.03%)、18(2.27%)。单一基因型感染率最高(20.51%,1 858/9 058),二重-六重及以上感染逐渐减少。各年龄组HPV中低危型及高危型感染率差异有统计学意义(P<0.01),混合感染率差异无统计学意义(P>0.05)。中低危型感染以≤20岁组最高,高危型感染率以41-60岁组最高,同一年龄组内均以高危型感染为主。不同就诊途径受检者HPV各型感染率组间差异有统计学意义(P<0.01),各组中低危型感染率在体检组最高,明显高于其它两组(P<0.01);门诊组和住院组以高危型为主,明显高于体检组(P<0.01)。住院患者不同疾病组间中低危型HPV感染率差异无统计学意义(P>0.01);高危型HPV感染率差异有统计学意义(P<0.01),恶性肿瘤组高危型感染率最高,其它组最低(P<0.01);各组高危型HPV感染率均明显高于中低危感染率(P<0.05)。结论:应加强湖北地区女性HPV的筛查力度,特别是HPV16、52、58、18四种最常见基因型的筛查,尤其针对41-60岁年龄组人群,可有效降低宫颈癌和由HPV引发的其它肿瘤或疾病发生率。  相似文献   

8.
目的探讨妊娠期合并亚临床甲状腺功能减退(亚甲减)患者血清促进甲状腺素(TSH),甲状腺过氧化物酶抗体(TPOAb)水平与妊娠结局的关系。方法选取2016年1月至2017年2月在我院定期接受产前检查、定期围产保健且住院分娩的亚甲减患者300例,根据有无接受治疗分为亚甲减治疗组(n=189)和亚甲减未治疗组(n=111);根据血清TSH中位数水平分为高TSH水平组(n=95)和低TSH水平组(n=205);并根据血清TPOAb检测是否为阳性分为TPOAb阳性组(n=182)与TPOAb阴性组(n=118)。另选取同期300例健康孕妇为对照组。对各组妊娠结局进行统计分析。结果亚甲减未治疗组流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率均明显高于亚甲减治疗组及对照组(P<0.05)。亚甲减孕妇中,高TSH水平组流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率均明显高于低TSH水平组(P<0.05);TPOAb阳性组流产、早产、GDM、妊娠期高血压疾病、低出生体重儿发生率均明显高于TPOAb阴性组(P<0.05)。结论妊娠合并亚甲减可增加流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率,且血清TSH水平越高及TPOAb阳性,不良妊娠结局风险越高。  相似文献   

9.
目的探讨利用自身免疫性甲状腺疾病患者中,血清甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(TgAb)水平联合血清纤维化四项检测,评价甲状腺组织纤维化的临床价值分析。方法选取我院就诊的174例患者,甲状腺相关自身抗体异常增高作为病例组;选取在我院体检科健康体检者25例,甲状腺相关自身抗体均正常作为对照组。采用化学发光法测定TPOAb、TgAb;采用放射免疫法检测纤维化四项包括:血清层黏蛋白(LN)、血清透明质酸(HA)、血清Ⅲ型前胶原氨端肽(PⅢNP)、血清IV胶原(CIV)。采用SPSS 21.0软件进行方差分析(ANOV)和t检验;Pearson相关性分析TPOAb、TgAb分别与纤维化四项的关系。结果阳性组与对照组、超声影像不同表现组比较,纤维化指标水平差异无统计学意义;血清TPOAb、TGAb分别与PⅢNP、CIV、LN、HA进行相关性分析(P>0.05),呈显著无相关。结论甲状腺自身抗体异常患者,甲状腺功能正常情况下,纤维化指标检测用于判断甲状腺纤维化的意义不大。  相似文献   

10.
目的 探讨影响初诊2型糖尿病(T2DM)患者甲状腺结节的危险因素.方法 选择北京市垂杨柳医院内分泌科2015年5月至2016年10月的初诊2型糖尿病患者239例.根据甲状腺彩超结果分为有结节组(n=79)和无结节组(n=160),进行初诊2型糖尿病患者甲状腺结节与临床指标、甲状腺功能的相关性分析.结果 初诊2型糖尿病患者甲状腺结节的患病率33.1%;女性患病率44.1%,明显高于男性患病率26.0%.两组间的年龄、血清25羟维生素D[25(OH)D]比较差异有统计学意义(P<0.05).Logistic回归分析结果显示女性、年龄、吸烟、甲状腺球蛋白抗体(TgAb)与甲状腺结节呈独立正相关(P<0.05).结论 女性、年龄、吸烟、TgAb是初诊2型糖尿病患者甲状腺结节的独立危险因素.  相似文献   

11.
OBJECTIVES: Thyroid autoimmunity is a major cause for hypothyroidism. We describe thyroid auto-antibodies in patients with various nosological subtypes of hypothyroidism identified in a population study. DESIGN: Population-based follow-up study identifying all new cases of hypothyroidism in an open cohort. METHODS: We established a monitoring system, and identified all new cases with primary overt hypothyroidism (n = 685) in a 4 year period in a well-defined population cohort (2,027,208 person-years of observation). Patients were sub-classified into: spontaneous hypothyroidism, presumably of autoimmune origin (n = 578); non-spontaneous hypothyroidism (associated with medication, delivery, neck-irradiation or subacute thyroiditis, n = 97); and congenital hypothyroidism (n = 10). A total of 186 adult patients (61% of those invited) underwent thyroid ultrasonography and measurements of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb). RESULTS: In spontaneously hypothyroid patients: >99% were antibody-positive (TPOAb or TgAb), TPOAb were more often measurable than TgAb (95.9 vs. 80.7%, p < 0.001). A statistically significant but modest correlation was observed between the two antibodies (Pearson's r2 = 0.11, p < 0.001). In a multivariate regression model both TPOAb and TgAb were positively associated with thyroid enlargement (p < 0.001), whereas no association was found with sex, age, iodine deficiency level or serum TSH level. We found no differences in patient characteristics between those who mainly developed TPOAb vs. those who preferentially harboured TgAb. CONCLUSIONS: Autoimmunity played a dominant role in practically all patients classified as spontaneously hypothyroid. Thyroid enlargement was associated with high levels of TPOAb and TgAb. We found no clue to why some spontaneously hypothyroid patients predominantly developed TPOAb whereas others mainly generated TgAb.  相似文献   

12.
Strong genetic susceptibility to thyroid autoantibody (TAb) diathesis has been shown and one of the major genes involved is probably CTLA-4 gene. Our recent study of patients with Graves' disease has demonstrated that exon 1 CTLA-4 gene polymorphism influences higher TAb production. Here, we evaluated the influence of exon 1 and promoter CTLA-4 polymorphisms on TAb production in 109 newly diagnosed patients with Hashimoto's thyroiditis (HT). Serum TSH, thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured. 49 A/G and -318 C/T polymorphisms were detected using polymerase chain reaction amplification of genomic DNA and restriction fragment length polymorphism analysis. Patients with AG and GG genotype had significantly higher TPOAb median values compared to patients with AA genotype (P < 0.003). Similarly, TgAb median value was significantly higher in AG patients and in the entire G-allele carrying group (P < 0.02). Compared to both T-allele carrying genotypes, CC genotype presented with significantly higher TPOAb median value (P < 0.02), whereas TgAb median values did not differ significantly between various genotypes. In conclusion, our results indicate that G allele influences higher TPOAb and TgAb production, whereas C allele affects especially TPOAb production in patients with HT. Therefore, our findings provide further evidence that CTLA-4 is a major TAb susceptibility gene.  相似文献   

13.
Background: Hashimoto’s thyroiditis (HT) is the most common form of autoimmune thyroid disorders characterized by lower production of thyroid hormones and positivity to autoantibodies to thyroglobulin (TgAb) and/or thyroid peroxidase (TPOAb). We performed a comprehensive phenotypic characterization of patients with HT, with specific focus on thyroid autoimmunity, to get better understanding of disease manifestation.

Methods: We collected information on thyroid-specific phenotypes (TSH, T3, T4, fT4, TgAb, TPOAb, thyroid volume) and other clinical phenotypes (age, body surface area, number of hypothyroidism symptoms, blood pressure) from 290 patients with HT without levothyroxine (LT4) therapy with the aim to test for correlations between thyroid-specific and clinical phenotypes.

Results: Our key and novel finding is the existence of significant positive correlation between TgAb levels and the number of symptoms (r = 0.25, p = 0.0001) in HT patients without LT4 therapy that remained significant after adjustment for TPOAb, T3, TSH levels and thyroid volume (β = 0.66, SE = 0.3, p = 0.0299). Increased TgAb levels are significantly associated with fragile hair (p = 0.0043), face edema (p = 0.0061), edema of the eyes (p = 0.0293) and harsh voice (p = 0.0349).

Conclusions: Elevated TgAb levels are associated with symptom burden in HT patients, suggesting a role of thyroid autoimmunity in clinical manifestations of HT. Based on these results, we recommend screening for TgAb antibodies in HT patients with symptom burden. We also suggest that further work on understandings of symptoms appearance due to their autoimmune or hypothyroid causation is needed.  相似文献   


14.
Objectives: Thyroid autoimmunity is a major cause for hypothyroidism. We describe thyroid auto-antibodies in patients with various nosological subtypes of hypothyroidism identified in a population study.

Design: Population-based follow-up study identifying all new cases of hypothyroidism in an open cohort.

Methods: We established a monitoring system, and identified all new cases with primary overt hypothyroidism (n = 685) in a 4 year period in a well-defined population cohort (2,027,208 person-years of observation). Patients were sub-classified into: spontaneous hypothyroidism, presumably of autoimmune origin (n = 578); non-spontaneous hypothyroidism (associated with medication, delivery, neck-irradiation or subacute thyroiditis, n = 97); and congenital hypothyroidism (n = 10). A total of 186 adult patients (61% of those invited) underwent thyroid ultrasonography and measurements of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb).

Results: In spontaneously hypothyroid patients: >99% were antibody-positive (TPOAb or TgAb), TPOAb were more often measurable than TgAb (95.9 vs. 80.7%, p < 0.001). A statistically significant but modest correlation was observed between the two antibodies (Pearson's r2 = 0.11, p < 0.001). In a multivariate regression model both TPOAb and TgAb were positively associated with thyroid enlargement (p < 0.001), whereas no association was found with sex, age, iodine deficiency level or serum TSH level. We found no differences in patient characteristics between those who mainly developed TPOAb vs. those who preferentially harboured TgAb.

Conclusions: Autoimmunity played a dominant role in practically all patients classified as spontaneously hypothyroid. Thyroid enlargement was associated with high levels of TPOAb and TgAb. We found no clue to why some spontaneously hypothyroid patients predominantly developed TPOAb whereas others mainly generated TgAb.  相似文献   

15.
The prevalence of autoantibodies against the 65 kD isoform of glutamic acid decarboxylase (GAD65Ab), insulin (IAA), islet cells (ICA), thyroid peroxidase (TPOAb) and thyroglobulin (TgAb), in relation to HLA-DR types, was assessed in 310 (HLA in 280) twelve-year-old children during three-year follow-up. Altogether, 26.8% (83/310) of the children were found to carry at least one autoantibody. The HLA-DR3/DR4 genotype was significantly more prevalent in the subgroup of children GAD65Ab-positive on at least one occasion than among GAD65Ab-negative children [33% (2/6) vs. 5% (12/274); p = 0.031, as was the HLA-DR4/x genotype among children seropositive for at least one thyroid autoantibody, compared to the corresponding seronegative subgroup 152% (34/65) vs. 34% (74/215); p=0.01]. The proportion of children seropositive in at least one of the three tests was 1.9% (6/310) for GAD65Ab, 2.6% (8/310) for IAA, 5.2% (16/310) for ICA, 11.3% (35/310) for TPOAb and 19.4% (60/310) for TgAb. All autoantibodies except GAD65Ab tended to disappear during follow-up, and at the three-year follow-up IAA had disappeared in 50% (2/4) of cases, ICA in 67% (6/9), TPOAb in 30% (6/20) and TgAb in 38% (18/47) of cases. The turnover of seropositive subjects and the large proportion of children seropositive for at least one islet or thyroid autoantibody during a three-year follow-up suggest transient autoantibodies to be more common than is discernible in cross-sectional investigations.  相似文献   

16.
目的 应用磁共振扩散成像技术探讨儿童皮质脊髓束年龄和性别差异及其变化规律。 方法 90例无中枢神经系统症状及体征且颅脑磁共振检查正常的儿童(年龄5d~18岁)。按年龄分为5组: 婴儿组(组1,≤1岁),幼儿组(组2,>1~3岁),学龄前组(组3,>3~6岁),学龄组(组4,>6~12岁),青春发育期组(组5,>12~18岁)。每个年龄组内再按性别分为男、女2组。各组儿童分别行头部扩散张量成像, 根据感兴趣法选取皮质脊髓束感兴趣区并重建,测量重建的皮质脊髓束的扩散张量参数并进行统计学分析。 结果 各年龄组的表观扩散系数(ADC)值、分数各向异性(FA)值、纤维示踪平均长度、体积以及示踪的纤维束数量不完全相同(P<0.01);组间的两两比较间发现,1组与2组间ADC值、FA值及示踪纤维平均长度差异具有统计学意义;2组与3组间FA值差异具有统计学意义;3组与4组间ADC值、FA值、示踪纤维平均长度、纤维束数目及体积差异均具有统计学意义。ADC值与年龄间呈负相关,余参数与年龄间呈正相关。结论 儿童皮质脊髓束发育具有阶段性,且具有阶段性特征;磁共振扩散张量技术可用于观测儿童皮质脊髓束,评价其发育状况。  相似文献   

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