白癜风患者维医辩证分型与血清甲状腺自身抗体及甲状腺素水平相关性研究

发布时间：2018-01-06 19:25

本文关键词：白癜风患者维医辩证分型与血清甲状腺自身抗体及甲状腺素水平相关性研究　出处：《新疆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过年龄和性别相匹配的原则,采用整群分层随机抽样方式抽取的482例白癜风患者为研究对象,106例健康人为对照组,采用化学发光免疫分析法检测血清中T3、T4、fT3、fT4、TSH、TGAB、TPOAb等甲状腺功能指标,按年龄、性别,白癜风不同分期,分型及维医异常粘液质分型等分层进行比较,分析白癜风患者维医辩证分型与甲状腺功能的相关性。方法:临床研究观察选取自治区维吾尔医院皮肤科住院白癜风患者,共482例病患入选,在自治区维吾尔医院门诊,保健科接受甲状腺功能检测的106健康人入选,空腹抽取肘静脉血5ml,室温静止1h,按时间循序编号,标记患者姓名与编号,保存在-80℃冰箱于每周内集中检测并结果记录下来。通过皮肤CT、Wood灯、全身黑光等检查确定白癜风患者分型,咨询患者的病史,最近3个月白斑有没有扩散等确定白癜风患者分期,根据维医辩证分析表及两名副主任医师以上维吾尔医专家的评价来确定患者的异常体液分型。最终把所有的数据记录下来,采用统计学方法进行多元统计,分析白癜风患者甲状腺功能与维医辩证分型的相关性。结果:共完成病例482例,对照组106例,两组人群在平均年龄、年龄分布、总体性别比以及各年龄段性别比上差异无显著性(P0.05),具有良好的可比性。两组人群在民族构成上有显著性差异(P0.05),维吾尔族最多,其次是汉族。病例组性别不同的患者白癜风临床分型分布无显著性差异(P0.05)。不同性别患者的维吾尔医异常体液分型分布有显著性差异,其中女性患者中咸味粘液质较多见(p=0.01),男性患者中涩味粘液质型较多见(P0.01),而淡味粘液质型、凝固样粘液质型之间差异没有统计学意义。病例组TGAB和TPOAb阳性率分别为11.2%和21.8%,显著高于健康对照组的1.9%和4.8%(P=0.002和0.001)。涩味粘液质型白癜风患者与非涩味粘液质型白癜风患者TGAB和TPOAb阳性率之间无显著性差异(p0.05)。不同临床分型的白癜风患者TGAB和TPOAb阳性率之间无显著性差异(p0.05)。各年龄段两组间TGAB阳性率差异无显著性(PO.05)。白癜风组18-45岁年龄段TPOAb阳性率显著高于同年龄段的健康人(P0.01),而小于18岁以及大于45岁两个年龄段两组间阳性率差异无显著性(P0.05)。涩味粘液质型白癜风组T3、T4和FT4水平显著高于非涩味粘液质型白癜风组(P0.05),而FT3和TSH水平的差异无显著性(P0.05)。涩味粘液质型白癜风T4的异常率显著高于非涩味粘液质型白癜风患者(P0.01),而T3、FT3、FT4和TSH异常率的差异无显著性(P0.05)。白癜风组T3、T4和FT3、FT4水平显著高于正常组(P0.01)。此外两组间TSH水平的差异无显著性(P0.05)。肢端性白癜风患者FT4水平显著高于其他临床分型(P0.01),而其余无显著性差异(P0.05)。结论:白癜风患者TGAB和TPOAb阳性率明显高于健康人。18-45岁年龄段白癜风患者TPOAb阳性率显著高于同年龄段的健康人,说明白癜风常伴发自身免疫性甲状腺疾病,而且18-45之间高发。涩味粘液质型白癜风T3、T4和FT4水平显著高于非涩味粘液质型白癜风患者。肢端性白癜风患者FT4水平显著高于其他临床分型。白癜风组T3和FT3异常率显著高于正常组。说明白癜风患者甲状腺功能检测具有重要临床意义,而且涩味粘液质可能影响甲状腺激素的降解,也可能是涩味粘液质白癜风和甲状腺功能异常的主要病因,这需要更进一步的研究。
[Abstract]:Objective: through matching the age and sex principle, with 482 cases of vitiligo patients from stratified random sampling as the research object, 106 healthy controls were determined by chemiluminescence immunoassay in serum T3, T4, fT3, fT4, TSH, TGAB, TPOAb and other parameters of thyroid function, according to the age vitiligo, gender, different stages, types and Uighur Medicine abnormal balgham type stratified comparison, correlation analysis of patients with vitiligo in Uyghur medicine dialectical type and thyroid function. Methods: the clinical study of hospitalized Uygur Autonomous Region Hospital Department of dermatology patients with vitiligo, a total of 482 patients enrolled in the outpatient hospital of Uygur Autonomous Region. Department of health care, accept thyroid function in 106 healthy people were selected, fasting venous blood 5ml, static at room temperature 1H number according to the time sequence, the patient's name and tag number stored in the -80 C refrigerator in a week In the centralized detection and record the results. Through the skin CT, Wood lamp, black light and other systemic examination to determine the type of vitiligo patients, consult the patient's medical history, the last 3 months have white spot diffusion to determine the staging of patients with vitiligo, according to Uighur medicine dialectical evaluation analysis and two associate chief physician of Uighur medicine experts to determine the type of the patients with abnormal helit. Finally put all the data recorded, using the statistical method of multivariate statistical analysis, the correlation of thyroid function in patients with vitiligo and doctor of dialectical type. Results: a total of 482 cases, 106 cases in the control group, the distribution of age among the two groups in mean age, sex ratio and overall. The age and sex ratio have no obvious difference (P0.05), has good comparability. There was significant difference in the ethnic composition of the two groups (P0.05), Uygur most, the second is the case group of Han nationality. Vitiligo patients in different clinical type distribution had no significant difference (P0.05). The abnormal body fluid in Uygur medicine patients with different types of distribution of gender has significant differences, in which women matter more salty mucus (p=0.01), more male patients see astringency phlegmatic type (P0.01), and mild phlegmatic the difference between the solidification type, like phlegmatic type was not statistically significant. The positive rate of cases in group TGAB and TPOAb were 11.2% and 21.8%, significantly higher than the healthy control group 1.9% and 4.8% (P=0.002 and 0.001). There was no significant difference between the astringency of phlegmatic type vitiligo patients and non astringent taste phlegmatic type TGAB and TPOAb in patients with vitiligo the positive rate (P0.05). There was no significant difference between the positive rate of TGAB and TPOAb in patients with vitiligo in different clinical types (P0.05). The difference of age between the two groups of TGAB positive rate had no significant (PO.05). The patients with vitiligo 18-45 age TPOAb The positive rate was significantly higher than that in healthy people the same age (P0.01), and less than 18 years old and 45 years old more than two age difference between the two groups was no significant (P0.05). The astringency of phlegmatic type vitiligo group of T3, T4 and FT4 were significantly higher than that of non astringent phlegmatic type vitiligo group (P0.05). The difference between FT3 and TSH levels had no significant difference (P0.05). The abnormal rate of astringency phlegmatic type T4 vitiligo was significantly higher than that of non astringent phlegmatic type vitiligo patients (P0.01), T3, FT3, FT4 and TSH abnormal rate of the difference was no significant (P0.05). T3 T4 and FT3 in vitiligo group, FT4. The level was significantly higher than the normal group (P0.01). In addition, the difference between the two groups no significant levels of TSH (P0.05). The level of FT4 in patients with acral vitiligo was significantly higher than that in other clinical classification (P0.01), while no significant difference (P0.05). Conclusion: Patients with vitiligo TGAB and TPOAb positive rate was significantly higher than that of healthy people.18-45 years of age The positive rate of TPOAb in patients with vitiligo were significantly higher than those of healthy people of the same age, vitiligo is often associated with autoimmune thyroid disease, and 18-45 high. The astringency phlegmatic type vitiligo T3, T4 and FT4 were significantly higher than that of non astringent phlegmatic type vitiligo patients. The level of FT4 in patients with acral vitiligo were significantly higher than those of other clinical types. Vitiligo group T3 and the abnormal rate of FT3 was significantly higher than the normal group. It has important clinical significance for detection of thyroid function in patients with vitiligo, and astringent mucus quality affecting the degradation of thyroid hormones, also may be the main cause of vitiligo and phlegmatic abnormal thyroid function astringency, which needs further study.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R29

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