儿童桥本甲状腺炎细胞形态分级与甲状腺功能和血常规参数的相关性研究

Study on the correlation between cytomorphology grading and thyroid functions and basic hematological parameters in children Hashimoto’s thyroiditis

目的 通过细针穿刺细胞病理学对儿童桥本甲状腺炎进行细胞形态学分级,并进一步探讨甲状腺功能、主要血常规参数与细胞形态学分级之间的相关性。方法 回顾性分析2017年1月—2020年12月在本院经B超、实验室检查及细针穿刺细胞病理学诊断为HT的40例患儿的病理涂片,根据细胞形态学分级标准进行分级。患儿均完善游离甲状腺素(FT4)、游离三碘甲状腺氨酸(FT3)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)及血常规等检查。结果 在40例患儿中,女性有33例。大多数患儿为桥本甲状腺炎2级(60%),其次是1级(32.5%)和3级(7.5%)。甲状腺激素升高者占7.5%,甲状腺功能减退者占72.5%,甲状腺功能正常者占20%。37.5%的患儿平均血红蛋白均降低,在甲状腺功能减退及亢进患儿中尤为明显(P<0.05)。其它血常规参数,与HT细胞形态学分级和甲状腺激素水平间无显著相关性(P>0.05)。结论 HT的细胞形态学分级可以客观反应患儿自身免疫性甲状腺炎的程度。细胞形态学分级与甲状腺功能无统计学相关性。本研究发现,大多数甲状腺功能减退及亢进患儿的血红蛋白水平较低,而其它血常规参数与甲状腺功能没有统计学相关性。

Objective To carried out cytomorphology grading of Hashimoto’s thyroiditis(HT) in children based on fine needle aspiration cytopathology, and to further explore the correlation between the cytological grades and thyroid function and basic hematological parameters.Methods The pathology smears of 40 children suffered with HT which were confirmed by B-scan ultrasonography, laboratory detection and fine needle aspiration cytopathology in our hospital during January 1;, 2017 and December 31;, 2020 were were retrospectively analyzed and graded according to the cytological grading standard. All patients had complete tests of free thyroxine(FT4), free triiodothyronine(FT3), thyroid stimulating hormone(TSH), thyroglobulin antibody(TGAb), thyroid peroxidase antibody(TPOAb) and basic hematological parameters. Results Of the 40 cases, 33 were females. Majority of the patients had grade 2 thyroiditis(60%), followed by grade 1(32.5%) and grade 3(7.5%). Elevated thyroid hormone was seen in 7.5% of the cases, with 72.5%of the patients presenting with hypothyroidism and 20% being euthyroid. Mean hemoglobin was decreased in 37.5% of these cases, and the decrease was more obvious in patients in hypothyroid and hyperthyroid state(P<0.05), while other hematological parameters had no significant correlation with cytomorphology grade and hormonal status(P>0.05).Conclusions Cytomorphological grading of HT could reflect the degree of this autoimmune disease in children. There was no significant statistical correlation between cytological grades and thyroid status. In this study, hemoglobin levels decreased in most of the hypothyroid and hyperthyroid cases while other basic hematological parameters did not show any statistically significant correlation with the thyroid hormonal status.