Graves病与D-二聚体、C反应蛋白的相关性研究
发布时间：2018-12-11 01:57
【摘要】：研究背景和目的:近年来,有报道指出,甲状腺机能亢进症(甲亢)常伴有凝血功能异常,亚临床甲状腺机能亢进症(亚临床甲亢)时即存在潜在高凝状态,临床上常被忽略。而D-二聚体和C反应蛋白是反映机体内高凝状态、血栓形成及纤溶活性的重要标志物。本研究通过对比Graves病患者与健康体检者血浆D-二聚体、C反应蛋白水平检测,探讨Graves病患者是否存在高凝状态及血栓形成倾向。研究方法:选取2014年3月至2015年2月于南昌大学第二附属医院内分泌门诊及住院的Graves病初诊患者共41例。随机抽取同时间段门诊健康体检者41例作为对照组,所有对象均以清晨空腹外周血为采血标本,酶联免疫法检测C反应蛋白(C reactive protein,CRP)、D-二聚体(D-dimer,D-D)水平。入组病例均排除有严重感染、心脑血管疾病、肝肾疾病、血液系统疾病、糖尿病、近期有服用华法林等抗凝药物者、妊娠期或哺乳期妇女等病者。数据处理采用SPSS 19.0进行统计学处理,计量资料检测数据以(sx±)表示,组间比较采用t检验,P0.05为差异有统计学意义;相关性检验采用Pearson相关性分析。研究结果:1、Graves病组D-D浓度为(0.8±0.6)ug/ml,对照组为(0.4±0.2)ug/ml,Graves病组的血浆D-D水平高于正常对照组,两者的差异具有统计学意义(t=4.802,P0.01);Graves病组的血浆CRP水平为(3.5±2.7)mg/l,对照组为(1.6±0.5)mg/l,Graves病组的血浆CRP水平高于正常对照组,两者的差异具有统计学意义(t=4.216,P0.01)。Graves病组与正常对照组促甲状腺激素(TSH)、血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)比较差异均具有统计学意义(P0.01)。2、Graves病组血浆CRP、D-D和甲状腺功能(FT3、FT4、TSH)、甲状腺自身抗体(TPOAb、TgAb)之间均未见统计学相关性。结论:Graves病患者D-D、CRP水平均高于正常对照者,表明Graves病患者体内血液处于高凝状态,有血栓形成倾向。Graves病患者血浆CRP和D-二聚体及甲状腺功能、甲状腺自身抗体之间均未见统计学相关性。提示甲状腺机能亢进时,血浆CRP和D-二聚体及甲状腺功能、甲状腺自身抗体之间不存在明显直接关联。
[Abstract]:Background and objective: in recent years, it has been reported that hyperthyroidism (hyperthyroidism) is often accompanied by abnormal coagulation function, while subclinical hyperthyroidism (subclinical hyperthyroidism) has potential hypercoagulability, which is often neglected clinically. D- dimer and C-reactive protein are important markers of hypercoagulability, thrombus formation and fibrinolytic activity. The aim of this study was to compare the levels of plasma D-dimer and C-reactive protein between patients with Graves disease and those with healthy controls to investigate whether the patients with Graves disease had hypercoagulability and thrombosis tendency. Methods: from March 2014 to February 2015, 41 patients with Graves's disease were selected from endocrine outpatient and inpatient department of the second affiliated Hospital of Nanchang University. Forty-one healthy people were randomly selected as control group. All subjects were collected from fasting peripheral blood in the morning. C-reactive protein (C reactive protein,CRP), D-dimer (D-dimer) were detected by enzyme-linked immunosorbent assay (Elisa). D-D) level. All patients were excluded from severe infection, cardiovascular and cerebrovascular diseases, liver and kidney diseases, blood system diseases, diabetes mellitus, recent patients taking warfarin and other anticoagulants, pregnant or lactating women and other diseases. Data processing using SPSS 19.0 for statistical processing, measurement data measured by (sx 卤), the comparison between groups using t test, P0.05 as the difference was statistically significant; correlation test using Pearson correlation analysis. The results showed that: 1 the D-D level in patients with Graves disease was (0.8 卤0.6) ug/ml, and (0.4 卤0.2) ug/ml,Graves disease, which was higher than that in normal controls. The difference between the two was statistically significant (t = 4.802, P0.01). The plasma CRP level in Graves disease group was (3.5 卤2.7) mg/l, control group was (1.6 卤0.5) mg/l,Graves disease group, and the plasma CRP level in Graves disease group was significantly higher than that in normal control group (t = 4.216, P < 0.05). P0.01 Serum free triiodothyronine (FT3), serum free thyroxine (FT4) and thyroglobulin antibody (TgAb), (TgAb),) in (TSH), patients with). Graves disease and normal controls There were significant differences in thyroid peroxidase antibody (TPOAb) (P0.01). 2Plasma CRP,D-D, thyroid function (FT3,FT4,TSH), thyroid autoantibody (TPOAb,) in patients with Graves disease. There was no statistical correlation between TgAb. Conclusion: the levels of D-DfCRP in patients with Graves disease are higher than those in normal controls, indicating that the blood of patients with Graves disease is in a state of hypercoagulability and tends to form thrombus. The plasma levels of CRP, D-dimer and thyroid function in patients with Graves disease are higher than those in normal controls. There was no statistical correlation between thyroid autoantibodies. It was suggested that there was no direct correlation between plasma CRP, D-dimer, thyroid function and thyroid autoantibodies in hyperthyroidism.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581.1
本文编号：2371648
[Abstract]:Background and objective: in recent years, it has been reported that hyperthyroidism (hyperthyroidism) is often accompanied by abnormal coagulation function, while subclinical hyperthyroidism (subclinical hyperthyroidism) has potential hypercoagulability, which is often neglected clinically. D- dimer and C-reactive protein are important markers of hypercoagulability, thrombus formation and fibrinolytic activity. The aim of this study was to compare the levels of plasma D-dimer and C-reactive protein between patients with Graves disease and those with healthy controls to investigate whether the patients with Graves disease had hypercoagulability and thrombosis tendency. Methods: from March 2014 to February 2015, 41 patients with Graves's disease were selected from endocrine outpatient and inpatient department of the second affiliated Hospital of Nanchang University. Forty-one healthy people were randomly selected as control group. All subjects were collected from fasting peripheral blood in the morning. C-reactive protein (C reactive protein,CRP), D-dimer (D-dimer) were detected by enzyme-linked immunosorbent assay (Elisa). D-D) level. All patients were excluded from severe infection, cardiovascular and cerebrovascular diseases, liver and kidney diseases, blood system diseases, diabetes mellitus, recent patients taking warfarin and other anticoagulants, pregnant or lactating women and other diseases. Data processing using SPSS 19.0 for statistical processing, measurement data measured by (sx 卤), the comparison between groups using t test, P0.05 as the difference was statistically significant; correlation test using Pearson correlation analysis. The results showed that: 1 the D-D level in patients with Graves disease was (0.8 卤0.6) ug/ml, and (0.4 卤0.2) ug/ml,Graves disease, which was higher than that in normal controls. The difference between the two was statistically significant (t = 4.802, P0.01). The plasma CRP level in Graves disease group was (3.5 卤2.7) mg/l, control group was (1.6 卤0.5) mg/l,Graves disease group, and the plasma CRP level in Graves disease group was significantly higher than that in normal control group (t = 4.216, P < 0.05). P0.01 Serum free triiodothyronine (FT3), serum free thyroxine (FT4) and thyroglobulin antibody (TgAb), (TgAb),) in (TSH), patients with). Graves disease and normal controls There were significant differences in thyroid peroxidase antibody (TPOAb) (P0.01). 2Plasma CRP,D-D, thyroid function (FT3,FT4,TSH), thyroid autoantibody (TPOAb,) in patients with Graves disease. There was no statistical correlation between TgAb. Conclusion: the levels of D-DfCRP in patients with Graves disease are higher than those in normal controls, indicating that the blood of patients with Graves disease is in a state of hypercoagulability and tends to form thrombus. The plasma levels of CRP, D-dimer and thyroid function in patients with Graves disease are higher than those in normal controls. There was no statistical correlation between thyroid autoantibodies. It was suggested that there was no direct correlation between plasma CRP, D-dimer, thyroid function and thyroid autoantibodies in hyperthyroidism.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581.1
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