甲状腺自身免疫抗体与丙型肝炎病毒感染的相关性研究

Correlation between thyroid autoimmune antibodies and hepatitis C virus infection

目的研究甲状腺自身免疫抗体(TAA)与丙型肝炎病毒(HCV)感染的相关性,为临床防治HCV感染提供参考。方法抽选郑州市2001年7月-2015年7月筛查到的298例TAA阳性患者,按性别和年龄匹配抽选同期300例TAA阴性患者作对照,分析血清抗-HCV水平及与TAA相关抗体的相关性;同时抽选同期156例丙型肝炎患者、150例正常健康人群和149例慢性乙型肝炎患者,分析其甲状腺相关指标的差异,采用Pearson相关分析对甲状腺过氧化物酶抗体(TpOAb)水平与血清抗-HCV相关性进行分析。结果 298例TAA阳性组中,HCV感染8例,感染率2.68%,300例TAA阴性组中,HCV感染4例,感染率1.33%,两组比较差异无统计学意义;而TAA阳性组的血清抗-HCV水平明显高于TAA阴性组(P<0.05);在TAA阳性组中,TpOAb水平与血清抗-HCV呈正相关(r=0.785,P<0.05);丙型肝炎患者的TpOAb、甲状腺球蛋白抗体(TgAb)阳性率分别为30.13%、31.41%,均明显高于慢性乙型肝炎组的8.05%、6.71%和正常组的9.33%、8.67%,差异有统计学意义(P<0.05)。结论 TAA异常未见HCV感染率增高,但TAA阳性人群中TpOAb水平与抗-HCV水平呈正相关,且丙型肝炎患者TpOAb、TgAb阳性率明显高于正常人和慢性乙型肝炎患者,提示丙型肝炎患者应注意监测甲状腺指标的变化。

OBJECTIVE To study the correlation between the thyroid autoimmune antibodies（TAA）and the hepatitis C virus（HCV）infection so as to provide guidance for prevention and treatment of HCV infection.METHODS A total of 298 patients with positive TAA who were screened out from Jul 2001 to Jul 2015 were extracted and enrolled in the study,meanwhile 300 patients who were negative for TAA were set as the controls according to the matching of ages and genders,the correlation between the levels of serum anti-HCV and the TAA was analyzed;during the same period,156 patients with hepatitis C,150 healthy people,and 149 patients with chronic hepatitis B were included in the study,the thyroid-related indicators were observed,and the Pearson analysis was performed to analyze the correlation between the thyroid peroxidase antibodies（TpOAb）levels and the serum antiHCV.RESULTS The HCV infection occurred in 8of 298 patients who were positive for TAA,with the infection rate 2.68%,the HCV infection occurred in 4of 300 patients who were negative for TAA,with the infection rate1.33%,and there was no significant difference between the two groups.The serum anti-HCV level of the positive TAA group was significantly higher than that of the negative TAA group（P〈0.05）.In the positive TAA group,the TpOAb level was positively correlated with the serum anti-HCV（r=0.785,P〈0.05）.The positive rates of TpOAb and thyroglobulin antibody（TgAb）of the patients with hepatitis C were respectively 30.13% and31.41%,significantly higher than 8.05% and 6.71% of the patients with chronic hepatitis B and than 9.33% and8.67% of the normal group（P〈0.05）.CONCLUSIONThe incidence of HCV infection is not increased in the patients with abnormal TAA levels,however,the TpOAb level of the patients with positive TAA is positively correlated with the anti-HCV level;the positive rates of TpOAb and TgAb of the hepatitis C patients are significantly higher than those of the healthy people and the chronic hepatitis B patients,indicating that the patients with hepatitis C should be paid attention to the change of the thyroid indicators.