类风湿关节炎与系统性红斑狼疮患者甲状腺功能的比较分析

Abnormal thyroid functions complicated by systemic lupus erythematosus and rheumatoid arthritis

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)与类风湿关节炎(rheumatoid arthritis,RA)患者并发自身免疫性甲状腺疾病(autoimmune thyroid disease,AITD)之间的差异。方法比较30例SLE患者(SLE组)、30例RA患者(RA组)与30例健康体检人群(对照组)并发AITD及甲状腺激素水平;比较SLE组、RA组常用实验室检查指标Hb、WBC、Plt、C3、C4、血沉(erythrocyte sedimentation rate,ESR)、C-反应性蛋白(C-reactive protein,CRP),并对甲状腺功能及甲状腺自身抗体与常用实验室检查指标的相关性进行分析。结果 SLE组与RA组并发AITD差异无统计学意义(P>0.05),但均高于对照组(P<0.05);RA组并发桥本氏甲状腺炎(桥甲炎)明显高于SLE组,差异有统计学意义(P<0.05);SLE组患者WBC、Plt、C3、C4、ESR、CRP水平低于RA组(P<0.05),两组上述实验室检查指标与甲状腺功能及甲状腺自身抗体均无显著相关性(P>0.05);RA组Hb与TT3、FT3水平有正相关趋势(r=0.485,r=0.409,均P<0.01),与TSH负相关(r=-0.428,P<0.05),免疫球蛋白IgG、IgA与TSH呈正相关(r=0.537,P<0.01;r=0.427,P<0.05)。结论 SLE和RA均易并发AITD尤其是甲状腺功能减退,AITD者要注意筛查是否并发RA或SLE。

Objective To explore the prevalence of autoimmune thyroid disease（AITD） complicated by systemic lupus erythe- matosus （SLE） and rheumatoid arthritis （RA）. Methods The prevalence of AITD and thyroid hormone levels were compared be- tween 30 SLE patients ,30 RA patients and 30 healthy volunteers. The laboratory tests （hemoglobin,white blood count, platelet C3, C4, erythroeyte sedimentation rate, C-reactive protein） were compared between SLE group and RA group. Finally, the correlations of thyroid function,thyroid autoantibodies and the laboratory tests were analyzed between SLE group and RA group. Results The prevalence of AITD in SLE and RA group was higher than that of the control group, but there was no significant difference between SLE group and RA group. However, the RA patients were more likely to have abnormal thyroid antibodies. The serum levels of white blood count, platelet, C3, C4, erythrocyte sedimentation rate and C-reactive protein in SLE group were lower than those in RA group, but no associations were found between the lab tests and thyroid function as well as thyroid autoantibodies in SLE group and RA group. In RA group, there was a positive correlation between hemoglobin and the serum level of 333 and FT3, but a negative correlation with TSH. The IgG and IgA had a positive correlation with TSH. Conclusions SLE and RA patients were likely to develop AITD, especially hypothyroidism. Health-care providers should pay attention to screening whether that is complicated by RA or SLE.