不同亚型自身免疫性甲状腺疾病患者血清25-（OH）D3的改变

Change of serum 25- （OH） D3 levels in patients with different subtypes of autoimmune thyroid diseases

目的探讨血清25-（OH）D3与自身免疫性甲状腺疾病（AITD）之间的关系。方法选取初诊Graves病（GD）32例、顽固性GD17例、缓解性GD10例、桥本甲状腺炎（HT）35例，健康查体者58名，检测血清25-（OH）D3和甲状腺自身抗体，包括促甲状腺素受体抗体（TRAb）、抗甲状腺球蛋白抗体（TGAb）、抗甲状腺过氧化物酶抗体（TPOAb）及甲状腺功能，并对25-（OH）D3水平与其他指标进行相关分析。结果与对照组相比，初诊GD组及HT组血清25-（OH）D3均显著降低[（50．75±17．60）、（36．63±21．65）、（43．05±19．53）μg/L]，差异均有统计学意义（P均〈0．05）。顽固性GD与缓解性GD组血清25-（OH）D3水平差异无统计学意义[（32．43±17．50）、（31．88±14．48）μg/L，P=0．866]，但与对照组相比，差异均有统计学意义（P均〈0．05）。GD组25-（OH）D3与TRAb、FT3、FT4、TSH之间无相关性，HT组25-（OH）D3与TGAb、TPOAb、FT3、FT4、TSH之间无相关性（P均〉0．05）。结论AITD患者外周血中25-（OH）D3的含量较对照组显著降低，推测维生素D的免疫抑制作用可成为治疗AITD的潜在手段，未来仍需进一步阐明25-（OH）D在AITD中发挥的具体作用。

Objective To investigate the relationship between serum 25-（OH） D3 and autoimmune thyroid diseases （ AITD ）. Methods Serum levels of 25-（ OH ） D3, thyroid antibodies （ thyroid stimulating hormone receptor antibody （ TRAb）, TGAb （ thyroid globulin antibody）, thyroid peroxJdase antibody （TPOAb） and thyroid function of 32 cases patients with Graves＇ diseases （ GD）, 17 cases patients without remission of GD, 10 cases patients with remission of GD, 35 cases patients with Hashimoto＇s thyroiditis （HT）, and 58 cases healthy subjects were measured, and the relationships between serum 25-（OH） D3 and the above clinical index were analyzed. Results The serum level of 25- （ OH ） D3 in patients with GD or HT were obviously lower than that in healthy subjects（ （50. 75±17. 60） μg/L, （36. 40±21.65） μg/L, （43.05±19. 53） μg/L,P〈0. 05）. No significant difference of the serum level of 25- （OH） D3 was found between patients refractory of GD and those with GD in remission（（32.43±17.50） μg/L, （31.88±14.48） μg/L,P= 0. 866）. However,compared with the normal control group ,both diseased groups showed significantly decrease （P〈0. 05 ）. No correlation was found between serum 25-（OH） D3 and TRAb,FT3 ,FT4 as well as TSH in GD group. No correlation was found between serum 25-（ OH ）D3 and TGAb, TPOAb （P〉 0. 05 ）. Conclusion Serum vitamin D levels are decreased in patients with AITD, which has been speculated as a potential therapeutic method for AITD, though further investigations are needed to establish the precise role of 25-（OH） D3 in AITD.