Graves病患者甲状腺肿大及眼征的影响因素分析

目的 探讨Graves病患者甲状腺肿大及眼征的影响因素.方法 选取皖北煤电集团总医院内分泌科2011年1月至2013年12月就诊的Graves病患者154例.分别按照患者有无甲状腺肿及有无甲状腺眼征,分为甲状腺肿大组(A组)和无甲状腺肿大组(B组)以及有眼征组(C组)和无眼征组(D组).应用化学发光法检测游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、甲状腺激素受体抗体(TRAb).分别比较两组患者的年龄、FT3、FT4、TSH、TPOAb、TGAb、TRAb .结果 154例患者中,甲状腺肿大者112例(72.7％),伴甲状腺眼征者62例(40.3％).甲状腺肿大组的FT3、FT4、TPOAb和TRAb均高于无甲状腺肿大组(P＜0.05),年龄小于无甲状腺肿大组(P＜0.01).有甲状腺眼征组的TPOAb、TGAb和TRAb均高于无甲状腺眼征组(P＜0.05).相关分析显示,甲状腺肿大与年龄、TPOAb、TRAb相关(相关系数分别为0.149、0.295、0.198,P＜0.05).甲状腺眼征与TGAb、TRAb相关(相关系数分别为0.280、0.228,P＜0.05).结论 Graves病患者甲状腺肿与年龄、高滴度的TPOAb和TRAb相关,甲状腺眼征与高滴度的TGAb和TRAb相关.

Influencing factors on goiter and thyroid eye in patients with Graves' disease

Objective To investigate the factors associated with goiter and thyroid eye of Graves'disease( GD) . Methods A total of 154 patients with GD were recruited in the study from Jan. 2011 to Dec. 2013. The patients were divided into two groups according to goiter and thyroid eye. Serum levels of free triiodothyronine(FT3), free thyroxine(FT4), thyroid stimulating hormone(TSH), thyroid peroxydase antibody( TPOAb) , thyroglobulin antibody( TGAb) and TSH receptors antibody( TRAb) were measured in chemiluminescence method. Age, FT3, FT4, TSH, TPOAb, TGAb and TRAb were compared between the two groups. Results In Graves'disease, there were 112 cases of goiter(72. 7％) and 62 cases of thyroid eye (40. 3％). Patients in group goiter showed higher FT3, FT4, TPOAb and TRAb. (P＜0. 05 or P＜0. 01), and lower age compared to those in group with no goiter(P＜0. 01). Patients in group thyroid eye showed higher TPOAb, TGAb and TRAb compared to those in group with no thyroid eye(P＜0. 05 or P＜0. 01). Correlation analysis showed goiter was related to age, TPOAb and TRAb (correlation coefficient=0. 149, 0. 295, 0. 198, P＜0. 05, respectively). Thyroid eye was related to TGAb and TRAb (correlation coefficient=0. 280,0. 228, P＜0. 05, respectively). Conclusion In Graves'disease, goiter is related to age, higher level of TPOAb and TRAb. Thyroid eye is related to higher level of TGAb and TRAb.