【摘要】 目的:探讨白癜风患者中甲状腺功能不全的发生率,以确定在这些患者中进行甲状腺功能筛查及甲状腺抗体检查的必要性。方法:收集2010年1月-2012年12月该院皮肤科门诊就诊的420例(男205例,女215例)白癜风患者,作为白癜风组,根据其皮损分布分为寻常型和节段型。对照组为213例健康成年志愿者(男113例,女100例)。以上所有成员均抽血接受甲状腺功能及甲状腺抗体的检查。甲状腺功能试验包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素刺激激素(TSH),方法采用电化学发光法。甲状腺抗体包括抗甲状腺球蛋白抗体(TgAb)和抗甲状腺过氧化物酶抗体(TPOAb),方法采用免疫荧光法。将白癜风组和对照组数据进行比较分析。结果:在白癜风组中,甲状腺功能不全者人数为56例(13.4%),而对照组中仅为11例(5.1%),差异有统计学意义(P<0.05)。在白癜风组中,寻常型白癜风组甲状腺功能不全者为47例(14.92%),节段型白癜风组中为9例(8.57%),差异亦有统计学意义(P<0.05)。在白癜风组中伴有其他疾病者共84例(20.1%),如糖尿病、变态反应性疾病、银屑病、斑秃、乙型肝炎、贫血等,但这些疾病的发生率在节段型和寻常型之间差异无统计学意义(P>0.05)。采用Logistic回归分析发现,甲状腺功能及抗体异常的发生率与白癜风的分型密切相关(OR=1.321,P<0.05);而与性别、分期等因素无关(OR=0.722、OR=0.653,P>0.05)。结论:在白癜风患者中有较高的甲状腺功能不全的发生率,寻常型明显高于节段型;而且白癜风经常先于甲状腺疾病发生。故在临床上对于尚未出现典型甲状腺疾病临床表现的白癜风患者进行甲状腺功能筛查及甲状腺抗体水平的检测非常有必要,可以早期诊断甲状腺疾病并及早干预,尤其是寻常型白癜风患者。更多还原

【Abstract】 Objective:To investigate the prevalence of thyroid dysfunction in a large cohort of patients with vitiligo in order to determine whether the routine tests of thyroid function and antibody levels are justified.Methods:A total of 420 outpatients(205 male,215 female) with vitiligo and 213 healthy volunteers(113male,100 female) were enrolled into the study from January,2010 to December,2012.Vitiligo patients were divided into segmental and non-segmental types.Electrochemiluminescence method was used to measure the blood levels of free triiodothyronine,free thyroxine and thyroid-stimulating hormone.Immumofluorescence technique was used to detect thyroglobulin and thyroid peroxidase antibody levels.Results:56 of 420 vitiligo patients(13.4%) exhibited thyroid dysfunction while llof 213 controls(5.1%) had thyroid dysfunction(P <0.05).In comparison with segmental vitiligo,more non-segmental vitiligo patients showed abnormal thyroid function(14.92%vs.8.57%,P<0.05).84(20.1%) vitiligo patients accompanied other diseases such as diabetes,allergic disorders,psoriasis,alopecia areata,hepatitis B,anemia,etc..The prevalence of accompanying other diseases was similar between segmental and non-segmental vitiligo(P > 0.05).Analysis with non-conditional Logistic regression model indicated that the type of vitiligo was associated with thyroid function,but not gender and the stage of vitiligo.Conclusions;Non-segmental vitiligo has a significantly higher incidence of thyroid dysfunction.Because vitiligo usually appears before the development of the thyroid diseases,it is necessary to examine thyroid function and antibody levels in patients with vitiligo,especially in those with nonsegmental vitiligo,which will facilitate earlier diagnosis and treatment of thyroid diseases.更多还原