不同贫血类型对老年人群甲状腺功能的影响

Effects of different types of anemia on thyroid function in elderly patients

目的探讨不同贫血类型对老年人群甲状腺功能的影响。方法从体检人群中筛选出388例老年贫血病人作为研究对象,将上述贫血病人按红细胞体积及血红蛋白浓度等指标分为大细胞性贫血、正细胞性贫血及小细胞低色素性贫血3种类型,同时纳入65例老年正常血红蛋白人群作为正常对照组,比较上述4组人群的甲状腺功能。结果与正常对照组相比,小细胞低色素性贫血组及正细胞性贫血组的游离甲状腺素(FT4)与游离三碘原氨酸(FT3)水平下降,TSH水平升高,但大细胞性贫血组及正细胞贫血组与正常对照组的FT4、FT3及TSH水平差异无统计学意义。贫血组内比较发现,小细胞低色素性贫血组的FT4水平显著低于其他2组贫血病人,FT3水平则较另2组贫血病人升高,而促甲状腺激素(TSH)水平在4组间无显著性差异。结论在不同贫血类型老年病人间,其甲状腺功能存在显著性差异,提示不同贫血类型对甲状腺激素的合成和代谢存在一定程度的影响。

Objective To evaluate the effects of different types of anemia on thyroid function in elderly patients. Methods A total of 388 elderly patients with anemia were enrolled in this study. By red blood cell volume and hemoglobin concentration, the patients with anemia were divided into microcytic hypochromic anemia group,large cell anemia group and normocytic anemia group. Sixty-five normal persons were enrolled as a normal control group. The thyroid function level was compared between the four groups. Results There were no significant differences in FT4,FT3 and TSH levels between large cell anemia group and normal control group. The level of FT4 in microcytic anemia group was significantly lower than that in the other three groups,and the level of FT3 was higher than that in the other two groups of anemia. There was no significant difference among the four groups in the level of TSH.Conclusions There are significant differences in thyroid function between different types of anemia,which suggests that different types of anemia have a certain degree of effect on the synthesis and metabolism of thyroid hormones.