成人斑秃与甲状腺自身免疫的关系分析

Association analysis between alopecia areata and thyroid autoimmunity in adults

目的评估成人斑秃患者甲状腺功能异常及甲状腺自身抗体的发生率，分析成人斑秃与甲状腺自身免疫的关系。方法按照预先设计的调查表收集斑秃患者人口学信息、病史、斑秃一级亲属家族史，并检测甲状腺功能和甲状腺过氧化物酶抗体（TPO—Ab）。结果共有209例患者入选，6．7％的患者伴发甲状腺疾病，20．6％的患者TPO—Ab阳性。与TPO—Ab阴性的患者比较，TPO—Ab阳性的患者斑秃首次发病年龄〈18岁（P=0．025）、发生全秃和（或）普秃（AT／AU）的概率更大（P=0．006）、合并甲状腺疾病的概率更大（P=0．002）、有更多的一级直系亲属成员患有斑秃（P=0．001）。结论斑秃患者TPO—Ab阳性率较高，即使无甲状腺受累的临床表现，也需对斑秃患者进行甲状腺功能及甲状腺自身抗体检测。

Objective To estimate the prevalence of thyroid dysfunction and thyroid autoantibodies in adults with alopeeia areata （AA）, and to analyze the relationship between alopecia areata （AA） and thyroid autoimmunity in adults. Methods A predesigned questionnaire was used to collect data on demographic information, medical history, and family history of AA in first-degree relatives from patients with AA. Thyroid function was evaluated, and anti-thyroid peroxidase antibody （TPO-Ab） was screened in all the patients. Statistical analysis was carried out by the chi-square test and Fisher＇s exact test. Results Totally, 209 patients with AA were enrolled. Of these patients, 6.7% were complicated by thyroid diseases, 20.6% were positive for TPO-Ab. Compared with the patients without TPO-Ab, those with TPO-Ab showed a significant increase in the proportion of patients with early-onset （〈 18 years） AA （χ^2 = 5.589, P = 0.025 ）, prevalenee rate of alopecia totalis/alopecia universalis （χ^2 = 9.990, P= 0.006） and thyroid diseases （χ^2 = 12.279, P= 0.002）, and incidence rate of AA in first-degree relatives （χ^2 = 14.426, P = 0.001 ）. Conclusions The positive rate of TPO-Ab is increased in patients with AA. It is recommended to evaluate thyroid function and to screen for thyroid autoantibodies in patients with AA despite of the absence of clinical manifestations of thyroid diseases.