HT伴甲状腺功能减退患者25(OH)D_(3)与甲状腺功能、甲状腺抗体的关系

Relationship among 25(OH)D_(3)and Thyroid Function and Thyroid Antibody in HT with Hypothyroidism Patients

目的:探讨桥本甲状腺炎(HT)伴甲状腺功能减退患者25羟维生素D_(3)[25(OH)D_(3)]与甲状腺功能、甲状腺抗体的关系。方法:选取2021年1月—2022年12月东莞市企石医院收治的60例HT伴甲状腺功能减退患者为研究对象。随机将其分为观察组与对照组,各30例。对照组给予左甲状腺素钠片,观察组在对照组基础上给予阿法骨化醇软胶囊。比较两组治疗前后甲状腺功能指标、甲状腺抗体及25(OH)D_(3)。分析所有患者25(OH)D_(3)水平与甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(TgAb)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))的相关性。结果:治疗后,两组TSH、FT_(4)、FT_(3)水平均转为正常,两组TSH、FT_(4)、FT_(3)水平比较,差异无统计学意义(P>0.05)。治疗后,观察组25(OH)D_(3)水平明显升高,且高于对照组,TPOAb、TgAb水平均降低,观察组TPOAb、TgAb水平均低于对照组,差异有统计学意义(P<0.05)。所有患者25(OH)D_(3)水平与TPOAb、TgAb均呈负相关(P<0.05)。结论:HT伴甲状腺功能减退患者25(OH)D_(3)水平与甲状腺抗体水平相关,补充维生素D能有效地降低甲状腺抗体水平,抑制甲状腺的自身免疫反应。

Objective:To investigate the relationship among 25 hydroxy vitamin D_(3)[25(OH)D_(3)]and thyroid function and thyroid antibody in Hashimoto thyroiditis(HT)with hypothyroidism patients.Method:A total of 60 patients with HT and hypothyroidism admitted to Dongguan Qishi Hospital from January 2021 to December 2022 were selected as the study objects.They were randomly divided into observation group and control group,30 cases in each group.The control group was given Levothyroxine Sodium Tablets,and the observation group was given Alfacalcidol Soft Capsules on the basis of the control group.Thyroid function indexes,thyroid antibodies and 25(OH)D_(3)before and after treatment were compared between the two groups.The correlation among the level of 25(OH)D_(3)and thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4))in all patients was analyzed.Result:After treatment,TSH,FT_(4)and FT_(3)levels of the two groups turned to normal,and there were no significant differences in TSH,FT_(4)and FT_(3)levels between the two groups(P>0.05).After treatment,the 25(OH)D_(3)level in observation group was significantly increased,and the 25(OH)D_(3)level in the observation group was higher than that in the control group,and the levels of TPOAb and TgAb decreased,and the levels of TPOAb and TgAb in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The level of 25(OH)D_(3)was negatively correlated with TPOAb,TgAb in all patients(P<0.05).Conclusion:The level of 25(OH)D_(3)in HT with hypothyroidism patients is correlated with the level of thyroid antibody.Vitamin D supplementation can effectively reduce the level of thyroid antibody and inhibit the autoimmune reaction of thyroid.