急性荨麻疹住院患者30例甲状腺功能回顾分析

Assessment of thyroid function in 30 inpatients with acute urticaria

目的：研究30例急性荨麻疹住院患者甲状腺功能指标的变化及与血常规、超敏 C 反应蛋白（hsCRP）、血细胞沉降率（ESR）等的相关性。方法回顾性分析30例急性荨麻疹住院患者三碘甲状腺原氨酸（TT3）、甲状腺素（TT4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）、抗甲状腺球蛋白抗体（TG-Ab）和抗甲状腺过氧化物酶抗体（TPO-Ab）水平，分析甲状腺功能与血常规（包括白细胞计数、中性粒细胞计数、血红蛋白）、hsCRP、ESR 等的相关性。结果患者组30例中有23例（76.7%）甲状腺功能指标存在异常，主要为 FT3、TT3、TT4低于正常范围，并显著低于健康对照组（t =6.39、5.55、3.57，均 P 〈0.01），而甲状腺自身抗体阳性率显著高于健康对照组（χ^2=7.68，P 〈0.01）。患者组白细胞、中性粒细胞、hsCRP 及 ESR 均较健康对照组明显升高（t =3.96、8.73、2.51、2.35，均 P 〈0.05），而血红蛋白水平较健康对照组显著降低（t =3.7，P 〈0.01）。相关性分析显示，患者的 FT3、TT3、TT4分别与血红蛋白水平呈正相关（r =0.63、0.59、0.37，均 P 〈0.05），FT3、TT3、TSH 分别与中性粒细胞呈负相关（r =-0.45、-0.50、-0.37，均 P 〈0.05），TT3与 hsCRP 也呈负相关（r =-0.39， P 〈0.05）。结论症状严重的急性荨麻疹患者在发病期普遍存在甲状腺功能异常，主要表现为低 T3综合征和甲状腺抗体阳性率增高，其与机体血红蛋白水平下降和感染存在一定相关性。

Objective To investigate changes of thyroid function indices and their correlation with blood routine examination results, high-sensitivity c-reactive protein（hsCRP）levels and erythrocyte sedimentation rate（ESR）in 30 inpatients with acute urticaria. Methods Thyroid function indices were retrospectively analyzed in 30 inpatients with acute urticaria （patient group）and 30 healthy controls （control group）, including total triiodothyronine （TT3）, total thyroxine （TT4）, free triiodothyronine （FT3）, free thyroxine （FT4）, thyroid-stimulating hormone （TSH）, anti-thyroglobulin antibody（TG-Ab）and anti-thyroid peroxidase antibody（TPO-Ab）. A correlation analysis was done between thyroid function indices and blood routine examination results （white blood cell [WBC]count, neutrophil count, hemoglobin）, hsCRP levels and ESR. Results Abnormal thyroid function indices were observed in 23 （23/30, 76.7%） patients with acute urticaria. Compared with the control group, the patient group showed significantly decreased levels of FT3, TT3, TT4 and hemoglobin（t = 6.39, 5.55, 3.57, 3.70, all P 〈 0.01）, but significantly increased positive rates of thyroid autoantibodies （χ^2 = 7.68, P 〈 0.01）as well as WBC counts, neutrophil counts, hsCRP levels and ESR （t = 3.96, 8.73, 2.51, 2.35, all P 〈 0.05）. There was a positive correlation between hemoglobin level and FT3, TT3, TT4 levels（r = 0.63, 0.59, 0.37, all P 〈 0.05）, but a negative correlation between neutrophil count and FT3, TT3, TSH levels（r = -0.45,-0.50, -0.37, all P 〈 0.05）, as well as between TT3 and hsCRP levels （r = -0.39, P 〈 0.05）in the patient group. Conclusion Patients with severe acute urticaria usually show abnormal thyroid function during attacks, which mainly manifests as low T3 syndrome and high positive rates of thyroid autoantibodies, and may be associated with decreased hemoglobin levels and infection.