维生素D对桥本甲状腺炎患者甲状腺自身抗体水平的影响探析

The Effect of Vitamin D on the Level of Thyroid Autoantibodies in Patients with Hashimoto's Thyroiditis

目的探析维生素D对桥本甲状腺炎患者甲状腺自身抗体水平的影响。方法选择2019年2—10月到该院治疗桥本甲状腺炎患者共260例作为观察对象,随机分为观察组和对照组,对照组130例患者患者接受基础治疗模式,观察组130例患者接受肌内注射维生素D药物。比较两组患者甲状腺功能、甲状腺抗体水平下降的比例以及25(OH)D上升的比例、甲状腺自身抗体与25(OH)D水平具有的相关性。结果两组患者在接受治疗3个月后的甲状腺功能水平趋于正常,各项指标变化不是十分明显,观察组患者血清促甲状腺素(TSH)、血清游离甲状腺素(FT4)、血清游离三碘甲腺原氨酸(FT3)分别为(-0.81±2.89)、(-0.15±1.45)、(0.09±1.31)pmol/L,对照组患者TSH、FT4、FT3指标分别为(-0.11±3.42)、(-0.03±1.21)、(0.16±1.49)pmol/L,差异无统计学意义(t=1.783、0.725、0.402,P>0.05);观察组内患者的TgAb、TPOAb、TRAb指标下降的比例和25(OH)D所上升的比例显著比对照组高,差异有统计学意义(χ^(2)=5.417、11.656、5.771、10.637,P=0.019、0.001、0.016、0.001);观察组患者TgAb指标、TPOAb指标以及TRAb指标水平和25(OH)D指标的水平呈负相关(P<0.05);对照组患者TPOA指标的水平和25(OH)D指标水平呈负相关(P<0.05),TRAb指标、TgAb指标和25(OH)D指标水平无相关性(P>0.05)。结论运用维生素D药物对桥本甲状腺炎患者的甲状腺自身抗体水平进行调节,具有较为显著效果,可以显著地改善患者的甲状腺抗体水平,改善临床症状,提升机体免疫力,维生素D药物可推广和运用在治疗桥本甲状腺炎疾病中。

Objective To explore the effect of vitamin D on the level of thyroid autoantibodies in patients with Hashimoto's thyroiditis.Methods A total of 260 patients with Hashimoto's thyroiditis treated in the hospital from February to October 2019 were selected as observation objects,and they were randomly divided into observation group and control group.130 patients in the control group received basic treatment mode,and 130 patients in the observation group received muscle Vitamin D drugs were injected internally.Compared the two groups of patients with thyroid function,the proportion of decreased thyroid antibody levels,the proportion of increased 25(OH)D,and the correlation between thyroid autoantibodies and 25(OH)D levels.Results The thyroid function level of the patients in the two groups tended to be normal after receiving treatment for 3 months,and the changes in various indicators were not very obvious.The observation group patients'serum thyroid stimulating hormone(TSH),serum free thyroxine(FT4),and serum free triiodine thyronine(FT3)was(-0.81±2.89)pmol/L,(-0.15±1.45)pmol/L,and(0.09±1.31)pmol/L,respectively.The indexes of TSH,FT4 and FT3 were(-0.11±3.42)pmol/L,(-0.03±1.21)pmol/L,and(0.16±1.49)pmol/L in the control group,respectively.The difference was not statistically significant(t=1.783,0.725,0.402,P>0.05).The ratio of decreased TgAb,TPOAb,and TRAb indicators in the observation group and the increased ratio of 25(OH)D were significantly higher than those in the control group,and the difference was statistically significant(χ^(2)=5.417,11.656,5.771,10.637,P=0.019,0.001,0.016,0.001).The observation group patients'TgAb,TPOAb,TRAb and 25(OH)D indicators showed a negative correlation(P<0.05);the control group patients'TPOA index levels and 25(OH)D The index level showed a negative correlation(P<0.05).There was no correlation between the levels of TRAb,TgAb and 25(OH)D(P>0.05).Conclusion The use of vitamin D drugs to regulate the level of thyroid autoantibodies in patients with Hashimoto’s thyroiditis has a significant effect.It can significantly improve the level of thyroid antibodies in patients,improve clinical symptoms,and enhance immunity.Vitamin D drugs can be promoted and used in the treatment of Hashimoto's thyroiditis disease.