甲状腺自身免疫抗体异常与多发性硬化相关性的研究

发布时间：2018-01-17 00:09

本文关键词：甲状腺自身免疫抗体异常与多发性硬化相关性的研究　出处：《昆明医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：[目的]本文通过对多发性硬化患者的甲状腺自身免疫抗体(ATA)、年龄、性别、病程、扩展残疾状况评分量表(EDSS)评分、治疗效果等情况的研究,了解ATA异常与多发性硬化的相关性,并为多发性硬化的治疗及预后的评估提供一定的参考。[方法]选取2014年1月至2016年1月于昆明医科大学第一附属医院神经内科住院的符合2010年McDonald诊断标准诊断的64名多发性硬化患者作为实验组。选取年龄及性别与实验组相匹配的健康工作人员及患者家属共74名作为对照组。采集入院时患者及正常对照组空腹静脉血,采用化学发光法行甲状腺功能检测。1.首先对比实验组与对照组中ATA阳性情况。2.其次,采集患者的一般情况、临床资料、随访治疗效果等,用二项式logistic回归分析分析患者ATA阳性的影响因素。3.在将患者按ATA情况分为ATA阳性组及阴性组,分别对比患者的年龄、性别、TSH、EDSS评分、脑脊液、病变部位等情况,研究两组间的差别。4.对比急性期及缓解期MS患者ATA异常的情况。采用SPSS17.0统计软件进行统计分析。[结果]1.与正常对照组相比,MS患者组合并ATA阳性率高(p0.05)；2.患者性别、年龄及除ATA以外的甲功指标异常与患者ATA阳性相关,女性患者更易合并ATA阳性,年龄越大越易合并ATA阳性,甲功其余指标异常者更易合并ATA阳性；3.ATA阳性组与ATA阴性组对比,ATA阳性者女性患者多见；ATA阳性者更大的可能性有TSH异常；ATA阳性患者残疾较ATA阴性组重(P0.05)。ATA阳性及阴性组对比,年龄、治疗后EDSS评分、脑脊液异常情况、有脊髓病变比例无统计学差异(P0.05)。4.MS患者急性期与缓解期对比,ATA阳性比例无统计学差异(p0.05)。[结论]多发性硬化患者合并甲状腺自身免疫性抗体比例较正常人群高,ATA可能对MS的病程和预后有一定的影响。ATA的检测越来越受到临床的重视,建议MS患者常规行甲状腺功能筛查,尤其是女性及年龄大者。对于β-干扰素、阿伦单抗等免疫调节治疗的MS患者在治疗期间应监测ATA变化。
[Abstract]:[Objective] to study the ATAA, age, sex, course of disease, extended disability scale (EDSS) and therapeutic efficacy of thyroid autoimmune antibody (ATAA) in patients with multiple sclerosis (MS). To understand the correlation between ATA abnormality and multiple sclerosis, and to provide some reference for the treatment and prognosis of multiple sclerosis. [Methods] from January 2014 to January 2016, 64 patients with multiple sclerosis who were admitted to Department of Neurology, first affiliated Hospital of Kunming Medical University were selected and diagnosed according to 2010 McDonald diagnostic criteria. The patients were selected as experimental group. 74 health workers and family members matched by age and sex were selected as control group. Fasting venous blood was collected from patients and normal control group. The thyroid function was detected by chemiluminescence method. Firstly, the positive rate of ATA was compared between the experimental group and the control group. Secondly, the general situation, clinical data and follow-up treatment effect of the patients were collected. Binomial logistic regression analysis was used to analyze the influencing factors of ATA positive in patients. The patients were divided into ATA positive group and negative group according to ATA. The age and sex of the patients were compared. TSHN EDSS score, cerebrospinal fluid, lesion location and so on. To study the difference between the two groups. 4. To compare the abnormal ATA of MS patients in acute phase and remission stage. SPSS17.0 statistical software was used for statistical analysis. [Results 1.Compared with the normal control group, the positive rate of ATA in patients with MS was higher than that in the control group (P 0.05). 2. The abnormal gender, age and the index of thyroid function other than ATA were associated with the positive ATA in the patients. The female patients were more likely to be associated with ATA positive, and the older the patients were, the more likely the patients were to be associated with ATA positive. Those with abnormal thyroid function were more likely to be associated with ATA positive. 3. ATA-positive group and ATA negative group were more common in female patients with positive ATA-positive. ATA positive patients were more likely to have abnormal TSH. The disability of ATA positive patients was more severe than that of ATA negative group. The age, EDSS score and cerebrospinal fluid abnormality after treatment were significantly higher in ATA positive group than in ATA negative group. There was no statistical difference in the proportion of spinal cord lesions. 4. There was no significant difference in positive ratio of ATA-positive between acute phase and remission stage in patients with MS (P 0.05). [Conclusion: the ratio of thyroid autoimmune antibodies in multiple sclerosis patients with thyroid autoimmune antibodies is higher than that in normal controls. The detection of AATA may have a certain effect on the course and prognosis of MS. It is suggested that MS patients should be routinely screened for thyroid function, especially in women and older people. The changes of ATA should be monitored in MS patients treated with immunomodulatory therapy such as 尾 -interferon and alenumab.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R744.51

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