幽门螺杆菌感染与甲状腺结节患者血清相关炎性因子的关系研究

Relationship between Helicobacter pylori infection and serum inflammatory factors in patients with thyroid nodules

目的分析幽门螺杆菌(HP)感染与甲状腺结节患者血清相关炎性因子的关系。方法选择2016年1月—2017年12月四川省宜宾市第二人民医院内分泌科诊治甲状腺结节患者150例进行临床研究。根据^(14)C-尿素呼气试验结果,将患者分为HP强阳性组(n=46)、弱阳性组(n=37)和阴性组(n=67),比较3组患者FT_3、FT_4、TSH、TPOAb、TGAb、IL-6、TNF-α、CRP水平变化情况,以及异常结果检出率。结果 3组患者FT_3、FT_4、TSH比较差异无统计学意义(P>0.05),TPOAb、TGAb差异具有统计学意义(F=14.296,P=0.000;F=4.318,P=0.014),其中HP强阳性组TPOAb、TGAb最高,HP阴性组最低,3组FT_3、FT_4、TSH、TPOAb、TGAb异常检出率比较差异具有统计学意义(χ~2=7.303,P=0.026;χ~2=6.483,P=0.039;χ~2=8.509,P=0.014;χ~2=17.432,P=0.000;χ~2=7.488,P=0.024),HP强阳性组患者各项指标检出率均明显高于其余2组;3组患者IL-6、TNF-α、CRP水平比较差异有统计学意义(F=7.829,P=0.000;F=6.416,P=0.037;F=3.422,P=0.042),HP强阳性组各项炎性因子水平均明显高于弱阳性组和阴性组;HP水平与FT_3、FT_4无相关性,与TSH、TPOAb、TGAb、IL-6、TNF-α、CRP水平呈正相关(r=0.605、0.382、0.441、0.713、0.527、0.449、P均<0.05)。结论 HP感染与甲状腺结节患者的甲状腺功能水平、炎性因子水平具有相关性,考虑HP可能为甲状腺结节发病的高危因素之一。

Objective To analyze the relationship between Helicobacter pylori(HP)infection and serum inflammatory factors in patients with thyroid nodules.Methods One hundred and fifty patients with thyroid nodules were selected from January 2016 to December 2017 in the Department of Endocrinology of the Second People's Hospital of Yibin City,Sichuan Province.According to 14C urea breath test results,the patients were divided into HP strong positive group(n=46),weak positive group(n=37)and negative group(n=67).The changes of FT 3,FT 4,TSH,TPOAb,TGAb,IL-6,TNF-α,CRP levels and the detection rate of abnormal results were compared among the three groups.Results There was no significant difference in FT 3,FT 4 and TSH between the 3 groups(P>0.05).The difference of TPOAb and TGAb was statistically significant(F=14.296,P=0.000;F=4.318,P=0.014),among which HP was strongly positive.The TPOAb and TGAb were the highest,the HP negative group was the lowest,and the abnormal detection rates of FT 3,FT 4,TSH,TPOAb and TGAb were statistically significant(χ^2=7.303,P=0.026;χ^2=6.483,P=0.039;χ2=8.509,P=0.014;χ^2=17.432,P=0.000;χ^2=7.488,P=0.024),the detection rate of all indexes in HP positive group was significantly higher than the other 2 groups;3 groups of patients The difference of IL-6,TNF-αand CRP levels was statistically significant(F=7.829,P=0.000;F=6.416,P=0.037;F=3.422,P=0.042).The levels of inflammatory factors in HP positive group were significantly higher than those in HP.There was no correlation between HP level and FT 3 and FT 4,and positive correlation with TSH,TPOAb,TGAb,IL-6,TNF-αand CRP levels(r=0.605,r=0.382,r=0.441,r=0.713,r=0.527,r=0.449,P<0.05).Conclusion HP infection is correlated with the level of thyroid function and inflammatory factors in patients with thyroid nodules.HP may be one of the high-risk factors for thyroid nodules.