摘要
目的探讨银屑病分型与甲状腺功能障碍的关系。方法收集复旦大学附属华山医院皮肤科2013年月至2018年10月临床确诊为银屑病并做过甲状腺功能检查的住院患者,共计468例。检测血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、总三碘甲状腺原氨酸(total triiodothyronine,TT3)、总甲状腺激素(total thyroxine,TT4)、促甲状腺激素(thyroid-stimulating hormone,TSH)、甲状腺球蛋白抗体(anti-thyrogloblin antibody,TGAb)和甲状腺过氧化物酶抗体(anti-thyroperoxidase antibody,TPOAb);分析寻常型、脓疱型、红皮病型和关节病型银屑病患者的甲状腺功能,比较各型银屑病中垂体-甲状腺轴各项激素和抗体水平的差异。结果寻常型银屑病患者血清垂体-甲状腺轴各项激素水平正常的比例更高( P <0.001),而在红皮病型银屑病患者中更易发生FT3或FT4下降但TSH正常( P <0.001)。脓疱型银屑病患者中FT3水平更低( P <0.05),红皮病型银屑病患者中FT4水平更低( P <0.05),关节病型银屑病患者中TSH水平更高( P <0.05)。各组银屑病患者TPOAb平均水平均高于正常值,但在4组银屑病患者中TPOAb和TGAb水平差异无统计学意义。结论银屑病与桥本氏甲状腺炎相关的甲状腺功能障碍存在一定的关联,尤其在非寻常型银屑病中,但在红皮病型银屑病中需注意合并正常甲状腺病态综合征的可能。
Objective To investigate the association of psoriatic subtypes with thyroid dysfunction. Methods A total of 468 psoriasis patients with clinical diagnosis of psoriasis and test results of thyroid function were enrolled from Huashan Hospital,Fudan University during Jan.2013 and Oct.2018.The following indexes were measured:free triiodothyronine (FT3),free thyroxine (FT4),total triiodothyronine (TT3),total thyroxine (TT4),thyroid-stimulating hormone (TSH),anti-thyrogloblin antibody (TGAb) and anti-thyroperoxidase antibody (TPOAb) in serum.Thyroid function was analyzed in psoriasis vulgaris,psoriasis pustulosa,erythroderma psoriaticum and psoriasis anthropathica patients.Pituitary-thyroid axis hormones and TPOAb,TGAb were compared in different psoriatic subtypes. Results There was higher prevelance of normal pituitary-thyroid axis hormones in psoriasis vulgaris patients ( P <0.001).The incidence of lower serum FT3 or FT4 level with normal TSH level was elevated in erythroderma psoriaticum patients ( P <0.001).Psoriasis pustulosa patients had lower FT3 level ( P <0.05),erythroderma psoriaticum patients had lower FT4 level ( P <0.05),and psoriasis arthropathica patients had higher TSH level in serum ( P <0.05).TPOAb was increased compared with the normal range in all subtypes of psoriasis patients.However,there was no significant difference of TPOAb and TGAb levels among the four subtypes. Conclusions There is some association between psoriasis and thyroid dysfunction induced by Hashimoto’s thyroiditis,especially in non psoriasis vulgaris individuals.Possibility of euthyroid sick syndrome should be considered in erythroderma psoriaticum patients.
作者
陆小年
陈荪奕
杜娟
杨叶虹
LU Xiao-nian;CHEN Sun-yi;DU Juan;YANG Ye-hong(Department of Dermatology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Endocrinology,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《复旦学报(医学版)》
CAS
CSCD
北大核心
2019年第5期657-661,共5页
Fudan University Journal of Medical Sciences
基金
国家自然科学基金面上项目(81673081,81670751)~~