甲状腺球蛋白基因外显子33单核苷酸多态性与Graves病停药后复发的相关性分析

发布时间：2018-02-16 18:21

本文关键词： Graves病甲状腺球蛋白单核苷酸多态性复发　出处：《中国病理生理杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:探究甲状腺球蛋白基因外显子33单核苷酸多态性(E33SNP)与Graves病(GD)复发的相关性,为临床预测GD抗甲状腺药物(ATD)治疗后的复发提供合理性依据。方法:选取健康对照者232例以及GD治疗后停药的患者243例,且根据GD停药患者的复发情况将观察组分为A、B、C 3个亚组:77例治疗后1年内复发者为A组,86例治疗后1~2年内复发者为B组,80例治疗后2年内未复发者为C组。利用RT-PCR检测对照组和观察组的E33SNP进行分型,对比分析对照组和观察组不同基因型的比率及观察组不同甲状腺球蛋白基因型患者的游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和促甲状腺激素受体抗体(TRAb)水平,以及眼征、甲状腺肿大程度等临床资料,且对观察组不同基因型患者在治疗后2年内的累积有效率进行对比分析。结果:观察组与对照组E33SNP的基因型差异无统计学显著性,但观察组各个亚组间E33SNP基因型差异具有统计学显著性(P0.05)。对观察组的A、B、C 3个亚组间不同基因型患者各项甲状腺功能相关指标进行对比分析表明,不同基因型患者的TSH、FT3、FT4水平及甲状腺肿大程度的差异无统计学显著性,而TRAb水平和眼征发生率的差异具有统计学显著性(P0.05)。此外,E33SNP T/T型GD患者ATD治疗后2年内的累积有效率为61.8%,E33SNP T/C型患者为42.6%,E33SNP C/C型患者为21.3%,差异具有统计学显著性(P0.05)。结论:E33SNP C/C型GD患者停药后的TRAb水平以及眼征发生率明显偏高,在ATD治疗后更加容易复发,E33SNP T/T型患者则呈现相反的趋势,复发率明显偏低,因此E33SNP C/C型GD患者采用其它治疗方式或者联合治疗方式可能更加合理。
[Abstract]:Objective: to investigate the association between thyroid globulin gene exon 33 single nucleotide polymorphisms (E33SNPs) and recurrence of Graves disease. Methods: 232 cases of healthy control and 243 cases of discontinuation of GD after treatment were selected. According to the recurrence of GD withdrawal patients, the observed group was divided into three subgroups: 77 patients with recurrence within 1 year after treatment, 86 patients with recurrence within 1 ~ 2 years after treatment and 80 patients with no recurrence within 2 years after treatment. E33SNP in control group and observation group were detected by RT-PCR. The ratio of different genotypes in the control group and the observation group and the levels of free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH) and thyrotropin receptor antibody (TRAb) in patients with different thyroglobulin genotypes were compared and analyzed. The clinical data of eye sign, goiter degree, and the cumulative effective rate of different genotypes in the observation group within 2 years after treatment were compared and analyzed. Results: there was no significant difference in the genotype of E33SNP between the observation group and the control group. However, the E33SNP genotypes were significantly different among the three subgroups in the observation group (P 0.05). The correlation indexes of thyroid function among the three subgroups of AZB C in the observation group were compared and analyzed, and the results showed that the E33SNP genotypes of the three subgroups were significantly higher than those of the control group (P < 0.05). There was no significant difference in the level of TSHTFT _ 3 FT _ 4 and the degree of thyroid enlargement in patients with different genotypes. In addition, the cumulative effective rate of E33SNP T / T GD patients within 2 years after treatment was 61.8% and 42.6% of the patients with E33SNP / C was 21.30.Conclusion the difference was statistically significant (P 0.05). The level of TRAb and the incidence of eye sign were significantly higher in patients with type C / C GD with E33SNP after withdrawal. The recurrence rate of patients with E33SNP / T type was lower than that of patients with E33SNP / T type after ATD treatment. Therefore, it may be more reasonable for patients with E33SNP C / C type GD to adopt other treatment or combined therapy.
【作者单位】：潍坊市人民医院内分泌科;潍坊市人民医院心内二科;潍坊市医学院研究生部;
【基金】：卫生部卫生公益性行业科研基金(No.201202008)
【分类号】：R581

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