甲状腺自身抗体及淋巴细胞浸润对桥本病甲状腺肿大程度的影响

Influence of thyroid autoantibody and thyroid lymphocyte infiltration on the size of thyroid in patients with Hashimoto's disease

目的探讨桥本病(Hashimotos disease,HD)甲状腺肿大程度与甲状腺功能状态、淋巴细胞浸润及自身抗体的相关性。方法 HD患者140例依据甲状腺肿大程度分为轻中度肿大组86例和重度肿大组54例,测定2组甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)及促甲状腺激素受体抗体(TSH receptors antibody,TRAb)水平,并行超声引导下细针穿刺组织细胞学活检,了解2组甲状腺淋巴细胞浸润程度,并比较分析2组情况。结果 2组TPOAb、TgAb、TPOAb/TgAb水平比较差异有统计学意义(P<0.05);2组TPOAb阳性率、TgAb阳性率、TPOAb强阳性率、TgAb强阳性率比较差异有统计学意义(P<0.05);甲状腺肿大程度与甲状腺淋巴细胞浸润程度、TPOAb强阳性率、TgAb强阳性率呈正相关(r=0.809,P=0.00;r=0.609,P=0.03;r=0.503,P=0.04);甲状腺淋巴细胞浸润程度与TPOAb、TgAb强阳性率呈正相关(r=0.992,P=0.00;r=0.901,P=0.04)。结论 HD患者甲状腺肿大程度与甲状腺淋巴结浸润程度、TPOAb强阳性和TgAb强阳性呈正相关,与甲状腺功能状态无关,监测TPOAb、TgAb可动态观测HD患者病情进展。

Objective To explore the correlation of goiter degree with thyroid function, thyroid lymphocyte infiltration and thyroid autoantibody levels in patients with Hashimoto＇s disease （HD）. Methods A total of 140 HD patients were divided into mild and moderate group （n=86） and severe group （n= 54） according to different goiter degrees. The levels of serum thyroid peroxidase antibody （TPOAb）, thyroglobulin antibody （TgAb） and TSH receptors antibody （TRAb） were detected in two groups. Ultrasound-guided fine needle aspiration biopsy cytology was applied to evaluate thyroid lymphocyte infiltration extent, and the results were compared between two groups. Results There were significant differences in TPOAb, TgAb, TPOAb/TgAb, the positive rates of TPOAb and TgAb, and the strong positive rates of TPOAb and TgAb between two groups （P^0.05）. The goiter degree was positively correlated with thyroid lymphocyte infiltration extent and strong positive rates of TPOAb and TgAb （r=0. 809, P=0.00; r=0. 609, P=0.03; r=0. 503, P： 0.04）. The thyroid lymphocyte infiltration extent was positively correlated with the strong positive rates of TPOAh and TgAb （r= 0. 992, P = 0. 00; r= 0. 901, P = 0. 04）. Conclusion The goiter degree is positively correlated with thyroid lymphocyte infiltration extent and the strong positive rates of TPOAb and TgAb in HD patients, and is not correlated with the thyroid function. Monitoring the levels of TPOAb and TgAb helps the dynamic observation of the progress of HD.