女性类风湿关节炎患者伴甲状腺功能异常临床研究

Clinical study of female rheumatoid arthritis patients with thyroid dysfunction

目的:探讨女性类风湿关节炎(RA)患者并发自身免疫性甲状腺疾病(ATD)的甲状腺功能状态与RA病情活动的相关性。方法:观察组选择女性RA患者100例,对照组选择正常体检女性57例,均进行甲状腺功能检测,并将观察组疾病活动度情况与甲状腺功能指标进行分析比较。结果:观察组女性RA患者100例中合并甲状腺功能异常37例,甲状腺功能正常63例。对照组57例中合并甲状腺疾病4例,甲状腺功能正常53例,两组比较差异有统计学意义(P<0.05)。观察组中甲状腺功能亢进2例,甲状腺功能减退14例,亚临床甲减7例,低T_3/T_4综合征14例,观察组中最常见的甲状腺疾病是甲状腺功能减退和低T_3/T_4综合征。对照组中亚临床甲减2例,低T_3/T_4综合征2例。观察组抗甲状腺抗体(TGAb、TPOAb)阳性率高于对照组(P<0.05)。观察组中甲状腺功能异常与正常比较,DAS28评分明显增高(P<0.05)。而RF、ESR、CRP、抗CCP、IgG、IgM、IgA、C_3、C_4比较无统计学差异(P>0.05)。结论:女性RA患者合并甲状腺疾病的发生率较高,且与RA病情活动度具有相关性,需要临床中重视。

Objective：To investigate the relationship between thyroid function status and RA activity in patients with rheumatoid arthritis（RA）complicated by autoimmune thyroid disease（ATD）.Methods：100 female patients with rheumatoid arthritis were enrolled in the study,and 57 healthy female controls as the control group.Thyroid function tests were performed.Statistical activity of the disease in the observation group was compared with that of thyroid function.Results：In the observation group,37 cases of thyroid dysfunction were found in 100 cases of female patients with RA,and 63 cases had normal thyroid function.Control group,57 cases of thyroid disease in 4 cases,53 cases of normal thyroid function,the difference between the two groups was statistically significant（P 〈0.05）.In the observation group,there were 2 cases of hyperthyroidism,14 cases of hypothyroidism,7 cases of subclinical hypothyroidism and 14 cases of low T3/T4 syndrome.The most common thyroid diseases in the observation group were hypothyroidism and low T3/T4 syndrome.Subclinical hypothyroidism in control group 2 cases,low T3/T4 syndrome in 2 cases.The positive rate of anti-thyroid antibody（TGAb,TPOAb）in the observation group was higher than that in the control group（P 〈0.05）.Thyroid dysfunction in the observation group compared with normal,DAS28 score was significantly higher（P〈 0.05）.RF、ESR、CRP、anti-CCP 、IgG、IgM、IgA、C3、C4 no significant difference（P〉0.05）.Conclusion：The incidence of thyroid diseases in women with RA is high,and it is correlated with the activity of RA.It needs clinical importance.