甲状腺疾病与贫血的相关性分析

发布时间：2018-01-31 05:40

本文关键词： 甲状腺激素促甲状腺激素甲状腺毒症甲状腺功能减退症贫血　出处：《南方医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究主要研究甲状腺疾病与贫血的相关性,分析甲状腺激素与红细胞相关指标的相关性及其对贫血的影响,为临床贫血查因及甲状腺疾病的诊疗提供实验依据。方法:本研究为回顾性分析,收集了 2012-01-01至2016-12-31初次在南方医科大学珠江医院就诊时,同一天检测了甲状腺功能(FT3、FT4、TSH)和血常规的患者的数据(剔除同一患者反复检测的数据),只保留甲状腺相关疾病的数据,剔除其他疾病的数据。按年龄将数据分成2组,14岁以上纳入总数据组,14岁及以下纳入儿童组,因儿童组数据不足,此次不纳入统计;14岁以上共收集14580例。根据实验室检查数据将样本分为甲状腺毒症组、亚临床甲亢组、甲减组、亚临床甲减组和正常组。将TSH进行对数转换后,各组检测指标用均数、标准差(X±S)进行描述,组间比较采用单因素方差分析。对甲状腺功能不同组贫血的患病率是否存在组间差异进行卡方检验。对甲状腺相关指标与红细胞相关指标之间是否存在相关性采用Pearson相关分析。以上统计均采用IBM SPSS 20.0版进行统计,P0.05时认为差异有统计学意义。结果:①14岁以上人群中,甲状腺毒症组和亚临床甲亢组的Hb、MCV、MCH均低于正常组,RDW高于正常组,而RBC和MCHC与正常组无显著性差异。甲减组的RBC、Hb、MCH低于正常组,RDW高于正常组,而MCV、MCHC与正常组无显著性差异;亚临床甲减组的RBC、Hb低于正常组,MCV、MCH、MCHC、RDW与正常组无显著性差异。②甲状腺毒症组、亚临床甲减组和正常组女性贫血的患病率均高于男性,而亚临床甲亢组和甲减组不同性别贫血的患病率无显著性差异。③甲状腺毒症组贫血的患病率随年龄增加有上升趋势,正常组贫血的患病率与年龄有关,但无明显线性趋势;亚临床甲亢组、甲减组和亚临床甲减组贫血的患病率与年龄无显著性相关。④甲状腺毒症组和亚临床甲亢组贫血的患病率均高于正常组,而甲状腺毒症组与亚临床甲亢组贫血的患病率无显著性差异。甲减组贫血的患病率高于亚临床甲减组,且甲减组和亚临床甲减组贫血的患病率均高于正常组。⑤甲状腺毒症组和甲减组贫血类型与正常组不同,亚临床甲亢组和亚临床甲减组贫血类型与正常组无显著性差异。甲状腺毒症组和甲减组小细胞低色素性贫血和正常细胞性贫血的患病率高于正常组,且正常细胞性贫血的患病率比小细胞低色素性贫血的患病率升高的更明显。甲功异常组与正常组贫血的程度无显著性差异。⑥0≤TSH0.35mIU/L或TSH10.0 mIU/L时贫血的患病率比0.35 mIU/L≤TSH ≤ 5.5 mU/L(参考区间)时高,而 5.5mIU/LTSH≤10mIU/L 时贫血的患病率与 0.35mIU/L≤TSH≤5.5 mU/L无显著性差异。⑦FT3、FT4与RBC始终呈正相关,TSH与RBC始终呈负相关;甲状腺毒症和亚临床甲亢时,FT3、FT4与Hb呈负相关;甲状腺功能正常、甲减和亚临床甲减时FT3、FT4与Hb呈正相关;甲减和亚临床甲减时TSH与Hb呈负相关,甲状腺毒症、亚临床甲亢和甲状腺功能正常时,TSH与Hb无显著性相关。结论:14岁以上人群中,FT3、FT4促进RBC生成,TSH抑制RBC生成;甲状腺毒症、亚临床甲减、甲减、亚临床甲减时均抑制Hb的合成。甲状腺疾病患者贫血的患病率升高,二者常并存,对于临床贫血查因及贫血的对症治疗无效的患者,应考虑甲状腺疾病的可能性。而对于甲状腺疾病患者,也应注意是否有合并贫血,是否需要同时纠正贫血。
[Abstract]:Objective: This study focuses on the correlation between thyroid disease and anemia, correlation analysis of thyroid hormone related to red blood cells and its effect on anemia, to provide the experimental basis for the diagnosis and treatment of acute anemia and thyroid disease. Methods: This study is a retrospective analysis, collection of 2012-01-01 to 2016-12-31 for the first time in Zhujiang Hospital of Southern Medical University. Detection of thyroid function the same day (FT3, FT4, TSH) and blood routine data of patients (excluding the same patients with repeated testing data), retaining only the thyroid related diseases, other diseases excluding data. Data will be divided into 2 groups according to age, over the age of 14 is included in the data set, and at the age of 14 the following into the group of children, because children are not included in the set of data, statistics over the age of 14; 14580 cases were collected. According to the laboratory examination data were divided into subclinical thyrotoxicosis group. The bed hyperthyroidism group, hypothyroidism group, subclinical hypothyroidism group and normal group. TSH after logarithmic transformation was used for each test index, standard deviation (X + S) are described. The comparison between groups using single factor analysis of variance on thyroid function in different groups. The prevalence of anemia whether there are differences between groups of cards whether there is square test. Pearson correlation analysis was performed between the thyroid related index and red blood cell index. The above statistics are using IBM SPSS version 20 statistics, P0.05 o.05indicatedstatisticaldifference. Results: 14 year olds in the thyroid gland, sepsis group and subclinical hyperthyroidism group Hb, MCV MCH, were lower than the normal group, RDW higher than the normal group, while RBC and MCHC had no significant difference with the normal group. The hypothyroidism group RBC, Hb, MCH lower than the normal group, RDW higher than the normal group, while MCV and MCHC had no significant difference with normal group; subclinical hypothyroidism group RBC, Hb Compared with the normal group, MCV, MCH, MCHC, RDW had no significant difference with the normal group. The thyrotoxicosis group, the prevalence rate of subclinical hypothyroidism group and normal group of anemia were higher than males, and subclinical hyperthyroidism group and hypothyroidism group different sex anemia prevalence rate had no significant difference between the thyroid gland. The prevalence of anemia in sepsis group with age increase with the normal group, the prevalence of anemia was associated with age, but no obvious linear trend; subclinical hyperthyroidism group and hypothyroidism group and subclinical hypothyroidism group the anemia prevalence rate and age had no significant correlation. The thyrotoxicosis group and the prevalence rate of subclinical hyperthyroidism the anemia group were higher than the normal group, and thyrotoxicosis group and subclinical hyperthyroidism group the prevalence of anemia. No significant difference in the prevalence of anemia is higher than that of hypothyroidism and subclinical hypothyroidism group, hypothyroidism group and subclinical hypothyroidism group the anemia prevalence rate is higher than the normal group 5. Thyrotoxicosis group and hypothyroidism group and normal group in different types of anemia, anemia group, subclinical hyperthyroidism and subclinical hypothyroidism group type had no significant difference with the normal group. The prevalence rate of thyrotoxicosis group and hypothyroidism group microcytic anemia and normal cell anemia is higher than the normal group, and normal cells the prevalence of anemia than microcytic hypochromic anemia prevalence rate increased significantly. There was no significant difference in thyroid dysfunction anemia group and normal group. The degree of anemia in 0 TSH0.35mIU/L or TSH10.0 mIU/L prevalence ratio 0.35 mIU/L 5.5 = TSH = mU/L (reference interval) high, and anemia 5.5mIU/LTSH the prevalence rate of less than 10mIU/L and 0.35mIU/L = TSH = 5.5. There was no significant difference in mU/L, FT3, FT4 and RBC always positively related to TSH and RBC were negatively correlated; thyrotoxicosis and subclinical hyperthyroidism, FT3, FT4 was negatively correlated with Hb; a The thyroid function was normal, hypothyroidism and subclinical hypothyroidism at FT3, FT4 was positively associated with Hb; hypothyroidism and subclinical hypothyroidism TSH negatively correlated with Hb, thyrotoxicosis, subclinical hyperthyroidism and normal thyroid function, no significant correlation between TSH and Hb. Conclusion: people over the age of 14, FT3, FT4 promote the formation of RBC, TSH inhibited RBC formation; thyrotoxicosis, subclinical hypothyroidism, hypothyroidism, subclinical hypothyroidism during the synthesis of Hb were inhibited. The prevalence of anemia in patients with thyroid diseases increased, two often coexist, for the symptomatic treatment of acute anemia and ineffective clinical anemia patients, should consider the possibility of thyroid disease. In patients with thyroid disease, should also pay attention to whether the patients with anemia, and whether you need to correct anemia.

【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R581;R556

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