氧化应激因子、甲状腺激素和血尿酸水平与痛风病情相关性研究

Relationship between oxidative stress,thyroid hormone,blood uric acid and gout

目的:分析氧化应激因子、甲状腺激素和血尿酸水平与痛风患者病情的关系,探讨痛风的发病机制。方法:收集72例痛风患者的临床资料、实验室指标和影像学资料等,并收集与其年龄匹配的30例健康人为正常对照组。对比两组血尿酸(UA)、晚期氧化蛋白产物(AOPP)、超氧化物歧化酶(SOD)水平和C-反应蛋白(CRP)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平。分析痛风中亚临床甲状腺功能减退症发生比例,比较两组氧化应激因子AOPP和SOD水平及UA、CRP水平的情况,比较单纯痛风组(n=36)与痛风合并骨破坏组(n=36)患者的AOPP、SOD水平及UA、CRP指标变化,并分析痛风患者AOPP与SOD、UA、CRP、TSH及病程间的相关性。结果:与正常对照组相比,痛风患者合并亚临床甲状腺功能减退症的发生率显著升高,差异有统计学意义(P<0.05);与正常对照组对比,痛风组SOD显著降低,UA、CRP及AOPP显著升高,差异有统计学意义(P<0.05);与单纯痛风组对比,痛风合并骨破坏组AOPP水平、CRP显著升高,SOD水平显著降低,差异有统计学意义(P<0.05),UA指标差异无统计学意义(P>0.05)。经Person相关性分析显示,AOPP与SOD呈显著负相关(P<0.05),与CRP、UA、TSH及病程均呈显著正相关(P<0.05)。结论:痛风患者伴亚临床甲状腺功能减退症发病率高于正常人,氧化应激参与了痛风疾病的进展,氧化应激反应与痛风患者的病程、CRP及痛风合并骨破坏存在显著相关性。

Objective:To analyze the relationship between oxidative stress,thyroid hormone,blood uric acid and gout,and to explore the pathogenesis of gout.Methods:The clinical data,laboratory indexes and imaging data of 72 gout patients(gout group)were collected,and 30 healthy people matched with age were selected as normal control group.The levels of serum uric acid(UA),advanced oxidation protein product(AOPP),superoxide dismutase(SOD),C-reactive protein(CRP),thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)were compared between the two groups.The incidence rate of subclinical hypothyroidism in gout group was analyzed.The levels of AOPP,SOD,UA and CRP were compared between the two groups.Between the simple gout group(n=36)and gout combined with bone destruction group(n=36),the levels of AOPP,SOD,UA and CRP were compared.The correlation between AOPP and SOD,UA,CRP,TSH and course of disease was analyzed.Results:Compared with the normal control group,the incidence of subclinical hypothyroidism in gout group was significantly increased,with statistically significant difference(P<0.05).Compared with the normal control group,SOD in gout group was decreased significantly,UA,CRP and AOPP were increased significantly,the difference was statistically significant(P<0.05).Compared with the simple gout group,the levels of AOPP and CRP in the gout combined with bone destruction group were significantly increased,the level of SOD was significantly decreased,the difference was statistically significant(P<0.05),but UA index had no significant difference.Person correlation analysis showed that AOPP was significantly negatively correlated with SOD(P<0.05),and significantly positively correlated with CRP,UA,TSH and course of disease(P<0.05).Conclusion:The incidence rate of sub-clinical hypothyroidism in gout patients is higher than that in normal people.Oxidative stress is involved in the development of gout.Oxidative stress reaction is significantly correlated with the course of gout patients,CRP and gout complicated with bone destruction.