甲状腺疾病红细胞碳酸酐酶测定的临床意义

Clinical significance of erythrocyte carbonic anhydrase concentration in different thyroid diseases

目的探讨甲状腺疾病患者甲状腺激素水平与红细胞碳酸酐酶(CA)浓度的关系。方法对38例甲状腺疾病患者包括Graves病组20例,原发性甲状腺功能减退症组(甲减组)10例,桥本甲亢组8例,随访4个月,观察甲状腺激素水平与红细胞CA浓度的变化,与28例健康对照进行比较。结果①Graves病组0、4、8周红细胞CA均低于对照组(P<0.001),至12周升至正常范围(P>0.05);甲减组与桥本甲亢组红细胞CA水平在0、4、12周均与对照组相似(P>0.05)。②入选时Graves病组与桥本甲亢组总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)水平相似(P>0.05),红细胞CA浓度Graves病组低于桥本甲亢组(P<0.05)。③Graves病组TT3、TT4恢复正常的比率在4、8、12周均高于0周(P<0.05),红细胞CA恢复正常的比率在4、8周均与0周相似(P>0.05),在12周时高于0周(P<0.001)。结论①红细胞CA浓度可用于鉴别Graves病及桥本甲亢患者的甲状腺毒症,对指导治疗具有一定意义。②红细胞CA浓度可反映甲状腺疾病患者8周前的甲状腺激素平均水平。

Objective Thyroid hormone and erythrocyte carbonic anhydrase （CA） concentration were measured in 38 patients with different thyroid diseases,and the relationship between them was researched. Methods Thirty-eight eases patients were divided into three groups：Graves disease 20,hypothyroidism 10 and Hashitoxicosis 8, healthy adults 28 served as control group. The level of serum triiodothyronine （T3） ,thyroxine （T4）, thyrotropie-stimulating hormone （TSH） and erythrocyte CA were measured once in four weeks for 16 weeks in all the subjects. Results OThe concentration of CA in Graves disease was significantly lower than that of control group in 0,4,8 weeks after treatment （ P〈0. 001）, but in the 12th week after treatment, the concentration of CA was in the normal range, there was no significant difference （ P〉0.05） compared with control group. There was no difference in the concentration of CA between Hashitoxicosis group,hypothyroidism （ P〉0.05） and their corresponding control groups. ① In 0 week, the levels of T3 and T4 were no significant difference between Graves disease and Hashitoxicosis groups （ P〉0.05）. The CA in Graves disease was significantly lower than in Hashitoxicosis group （P〈0.05）. ②In Graves disease, the normalization ratio of T3 and T4 in 4,8 weeks after treatment was higher than that in 0 week （ P〈0.05） respectively. There was no significant difference on the normalization ratio of CA in 4,8 weeks after treatment compared with that in 0 week （ P 〉0.05） respectively,but it was higher in the 12th week than that in 0 week （ P〈0. 001）. Conclusion ①The erythrocyte concentration of CA can be used in the differentiation between Graves disease and Hashitoxicosis. And it could be used to guide therapy in different causes of thyrotoxicosis. ②The erythrocyte concentration of CA reflects the mean level of the thyroid hormone measured 8 weeks earlier in the different thyroid diseases.