甲状腺自身免疫性抗体与丙型肝炎病毒感染的相关性分析

Study on the correlation between anti-thyroid autoantibodies and hepatitis C virus infection

目的探讨自身免疫性甲状腺病、甲状腺自身抗体与HCV感染的相关性。方法选取甲状腺过氧化物酶抗体（TPOAb）和（或）甲状腺球蛋白抗体（TgAb）阳性者462例，分别选取年龄和性别匹配的TPOAb和TgAb阴性者380例作为对照，检测血清抗一HCV，阳性者进一步作HCVRNA定性检测。同时，选取临床诊断的195例丙型肝炎患者作病例组，并选取年龄和性别匹配的150名健康人和150例乙型肝炎患者作对照组，行甲状腺相关指标的测定。采用独立样本t检验和χ^2检验。结果甲状腺自身抗体阳性组462例患者中，HCV感染阳性率为1．30％，阴性组380例中HCV感染阳性率为0．53％，差异无统计学意义（χ^2=1．322，P〉0．05）。丙型肝炎患者的TPOAb阳性率为30．8％，TgAb阳性率为30．8％，均显著高于乙型肝炎患者和健康人（χ^2=21．496，χ^2=30．454；P〈0．01）。结论甲状腺自身免疫异常者未见HCV感染率增高，而丙型肝炎患者甲状腺自身抗体阳性率增高，提示丙型肝炎患者应注意检测甲状腺相关指标。

Objective To explore the correlation between anti thyroid autoantibodies and hepatitis C virus （HCV） infection. Methods Four hundred and sixty-two samples with positive thyroid peroxidase antibody （TPOAb） and （or） thyroglobulin antibody （TgAb） were collected. Three hundred and eighty age and gender matched subjects with negative TPOAb and TgAb were selected as controls. The anti-HCV antibody was examined in all the cases using the third-generation enzyme linked immunosorbent assay （ELISA）, HCV RNA qualitative examination was examined further in those who had positive anti HCV antibody. Meanwhile, 195 subjects with hepatitis C, 150 healthy subjects and I50 subjects with hepatitis B were tested for thyroid related markers. The data were analyzed by independent-sample t test and chi square test. Results The HCV infection rate in 462 thyroid autoantibodies positive subjects was 1.30% and 0.53% in 380 thyroid autoantibodies negative subjects. There was no significant difference of the HCV infection rate between two groups （χ^2 = 1. 322, P〉0.05）. In the subjects with hepatitis C, 30.8% were TPOAb positive, 30.8% were TgAb positive, which were significantly different from those of healthy subjects and subjects with hepatitis B （χ^2 = 21. 496, χ^2= 30. 454; P〈0.01）. Conclusions HCV infection rate does not increase in subjects with abnormal thyroid autoimmunity. However, positive rate of thyroid autoantibodies increases in subjects with hepatitis C, which suggests that thyroid related markers should be examined in hepatitis C patients.