河北医科大学学报

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石家庄市汉族初诊桥本甲状腺炎患儿25羟维生素D状况分析

  

  1. 1.河北医科大学第二医院小儿内科,河北 石家庄 050000;2.河北省临城县人民医院儿科,河北 临城 054300
  • 出版日期:2019-04-25 发布日期:2019-04-22
  • 作者简介:皮亚雷(1982-),女,河北行唐人,河北医科大学第二医院主治医师,医学硕士,从事小儿内科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20160550)

Analysis of 25 hydroxyvitamin D status in newly diagnosed Han children with Hashimoto thyroiditis in Shijiazhuang city#br#

  1. 1.Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang
    050000, China; 2.Department of Pediatrics, Lincheng People′s Hospital,
    Hebei Province, Lincheng 054300, China
  • Online:2019-04-25 Published:2019-04-22

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨桥本甲状腺炎(Hashimoto thyroiditis,HT)患儿维生素D状况及维生素D在HT发病机制中的作用。
〖HTH〗方法〖HTSS〗〖KG*2〗收集石家庄市汉族HT患儿61例。按初诊日期分为夏秋季组(初诊日期6—11月)及冬春季组(初诊日期12月至次年5月);按初诊年龄分为<10岁组及≥10岁组。采集晨起空腹静脉血4 mL,测定所有患儿促甲状腺激素(thyrotropin,TSH)、总甲状腺素(total thyroxin,TT4)、游离甲状腺素(free thyroxine,FT4)、总三碘甲腺原氨酸(total triiodothyronine,TT3)、游离三碘甲腺原氨酸(free triiodothyronine,FT3)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白(thyroglobulin,TG)、甲状腺球蛋白抗体(thyroglobulin antibody,TGAb),25羟维生素D(25 hydroxyvitamin D,25OHD)水平;超声测定甲状腺左右叶长、宽、厚度,计算甲状腺体积;电化学法测定晨起中段尿尿碘。
〖HTH〗结果〖HTSS〗〖KG*2〗61例HT患儿25OHD水平为(47.50±17.88) nmol/L,缺乏者15例(24.59%),不足者19例(31.15%),充足者27例(44.26%)。夏秋季组初诊患儿25OHD水平为(55.15±1861) nmol/L,冬春季组初诊患儿25OHD水平为(42.55±15.73) nmol/L,夏秋季组高于冬春季组(P<005),2组甲状腺相关实验室参数未见差异。<10岁组患儿25OHD水平为(49.14±18.15) nmol/L,≥10岁组为(45.81±17.75) nmol/L,2组差异无统计学意义(P>005),2组甲状腺相关实验室参数亦未见差异。血清25OHD水平与TG水平负相关(rs=-0.348,P=0006),与甲状腺体积、TSH、TT4、FT4、TT3、FT3、TGAb、尿碘均无相关性(P>0.05)。
〖HTH〗结论〖HTSS〗〖KG*2〗HT患儿血清25OHD未见明显降低,但仍然存在季节性变化;血清25OHD水平可能并不影响HT患儿实验室及临床参数。

关键词: 桥本病, 维生素D, 儿童

Abstract: [Abstract] Objective〖HTSS〗〓To investigate the 25 hydroxyvitamin D status in children with Hashimoto thyroiditis(HT) and the role of vitamin D in the pathogenesis of HT.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixtyone children with HT in Shijiazhuang Han nationality were collected. The patients were divided into summerautumn group (JuneNovember) and winterspring group (December to May of the following year) according to the date of first visit, and <10 years old group and ≥10 years old group according to the age. Four milliliters of fasting venous blood samples were collected to test thyrotropin(TSH), total thyroxin(TT4), free thyroxine(FT4), total triiodothyronine(TT3), free triiodothyronine(FT3), thyroid peroxidase antibody(TPOAb), thyroglobulin(TG), thyroglobulin antibody(TGAb) and 25 hydroxyvitamin D(25OHD) level. The lengths, widths and thicknesses of the right and left lobes of the thyroid were measured by ultrasound and the volume of thyroid was calculated, and the iodine in the morning midstream urine was measured by electrochemical method.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The level of 25OHD in 61 children with HT was (47.50±1788) nmol/L, 15 cases(24.59%) were deficient, 19 cases(31.15%) were insufficient  and 27 cases(44.26%) were sufficient. The levels of 25OHD were (55.15±18.61) nmol/L and (42.55±15.73) nmol/L in summerautumn group and winterspring group respectively. The summerautumn group were higher than the winterspring group(P<005). There was no difference in thyroid related laboratory parameters between the two groups. The levels of 25OHD were (49.14±18.15) nmol/L and (45.81±17.75) nmol/L in groups of<10 years old and≥10 years old respectively. There was no significant difference between the two groups(P>005). There was no difference in thyroid related laboratory parameters between the two groups either. Serum 25OHD level was negatively correlated with TG(rs=-0.348, P=0006), and there was no correlation between 25OHD and thyroid volume, TSH, TT4, FT4, TT3, FT3, TGAb and morning midstream urinary iodine(P>005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The serum 25OHD level in children with HT was not significantly decreased, and the seasonal changes were still present. The serum 25OHD level may not affect the laboratory and clinical parameters of children with HT.

Key words: Hashimoto disease, vitamin D, child