Graves甲亢与血清肝纤维化指标相关性研究

A Study on the Correlation Between Graves’ Hyperthyroidismand Serum Hepatic Fibrosis Index

目的通过研究Graves甲亢患者血清中透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型胶原N端肽(PⅢPN-P)、Ⅳ型胶原(CⅣ)水平的变化,来探讨甲状腺功能亢进对肝纤维化的影响,并讨论抗甲状腺激素受体抗体(TRAb)与肝纤维化指标的相关性。方法采用化学发光法检测65例Graves甲亢患者和65例健康体检者血清中HA、LN、PⅢPN-P、CⅣ的水平,电化学发光法检测甲功三项(TSH、FT 3、FT 4)及TRAb。组间差异性分析采用t检验,相关性分析采用Pearson检验。结果HA、LN、PⅢP N-P、CⅣ在甲亢患者中的阳率性分别为1.50%、4.60%、63.10%和49.20%。甲亢患者血清中的PⅢP N-P及CⅣ平均水平分别为50.48±19.62ng/mL及33.78±16.06ng/mL,与对照组相比,差异有统计学意义(P<0.05),而HA与LN差异无统计学意义。研究还发现,随着TRAb水平的升高,PⅢP N-P及CⅣ的水平也随着升高,且差异有统计学意义(P<0.05)。相关性检验结果显示,TRAb与PⅢP N-P与CⅣ均存在正相关。结论甲亢患者中肝纤维化指标PⅢP N-P及CⅣ水平显著高于正常人,且TRAb与PⅢP N-P及CⅣ存在显著正相关性。因此,甲亢患者有必要关注肝纤维化的问题。

Objective To investigate the effect of hyperthyroidism on hepatic fibrosis and to evaluate the correlation between anti-thyroid hormone receptor antibody(TRAb)and liver fibrosis indexes by testing changes of hyaluronic acid(HA),laminin(LN),typeⅢcollagen N-terminal peptide(PⅢP N-P)and typeⅣcollagen(CⅣ).Methods Levels of HA,LN,PⅢP N-P and CⅣin 65 patients with Graves’hyperthyroidism and 65 healthy subjects were determined by chemiluminescence method.TSH,FT 3,FT 4 and TRAb were detected by electrochemiluminescence immunoanalyzer.For data analysis,t test was applied for comparison analysis and Pearson test was conducted for correlation analysis.Results The positive rates of HA,LN,PⅢP N-P and CⅣin hyperthyroid patients were 1.50%,4.60%,63.10%and 49.20%,respectively.PⅢP N-P and CⅣlevels in hyperthyroidism patients were 50.48±19.62 ng/mL and 33.78±16.06 ng/mL.Compared with the healthy control group,these results were significantly different(P<0.05),while there was no significant difference between HA and LN.Significant difference was also observed in PⅢP N-P and CⅣ,while the TRAb level increased(P<0.05).Correlation test showed that there was a positive correlation between TRAb and PⅢP N-P,as well as CⅣ.Conclusion The contents of PⅢP N-P and CⅣin hyperthyroidism patients are significantly higher than those in normal controls,and there is a significant positive correlation between TRAb and PⅢP N-P,as well as CⅣ.Based on these results,patients with hyperthyroidism need to pay attention to the condition of liver fibrosis.