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目的:探讨甲状腺功能正常但甲状腺过氧化物酶抗体(TPOAb)阳性的慢性丙型肝炎(CHC)患者干扰素治疗前后血清中TPOAb Ig G1、Ig G2、Ig G3、Ig G4的分布及其意义。方法:收集甲状腺功能正常但TPOAb阳性的CHC患者46例,按应用聚乙二醇干扰素(Peg-IFNα-2a)联合利巴韦林(RBV)抗病毒治疗过程中甲状腺功能(包括FT3、FT4、TSH)情况分为正常组和异常组。采用酶联免疫吸附测定法(ELISA)检测治疗前后患者血清中TPOAb Ig G各亚型的百分结合率,比较两组患者治疗前后TPOAb Ig G亚型的变化,进而分析该变化与合并甲状腺功能异常的相关性。结果:146例TPOAb阳性的CHC患者治疗过程中甲状腺功能异常者为35例,占76.09%,其中甲状腺功能减退(甲减)19例,占41.30%,甲状腺功能亢进(甲亢)3例,占6.52%,亚临床甲减12例,占26.09%,亚临床甲亢1例,占2.17%。2异常组抗病毒治疗前后TPOAb Ig G2亚型阳性率均高于正常组(P值分别为0.005和0.036),TPOAb Ig G1、Ig G3、Ig G4阳性率在正常组和异常组间的差异均无统计学意义(P>0.05)。结论:伴TPOAb阳性CHC患者应用干扰素治疗前检测其血清中TPOAb Ig G2亚型可预示抗病毒治疗过程中甲状腺功能异常,尤其是甲减及亚临床甲减发生的可能性,有助于指导临床监测和及时检出甲状腺功能异常。
Objective: To investigate the distribution and significance of serum TPOAb Ig G1, Ig G2, Ig G3 and Ig G4 in patients with chronic hepatitis C (CHC) positive for thyroid function but positive for thyroid peroxidase (TPOAb) before and after interferon treatment. Methods: Forty-six CHC patients with normal thyroid function but TPOAb positive were collected. Thyroid function (including FT3, FT4 and FT4) in patients with Peginterferon (Peg-IFNα-2a) and ribavirin , TSH) The situation is divided into normal group and abnormal group. The percentage of TPOAb Ig G subtypes in serum of patients before and after treatment was detected by enzyme-linked immunosorbent assay (ELISA), and the changes of TPOAb Ig G subtypes before and after treatment were compared between the two groups. Then the changes were compared with thyroid function Abnormal correlation. Results: Thirty-six patients with TPOAb-positive CHC had abnormal thyroid function in 35 cases, accounting for 76.09%, of which 19 cases were hypothyroidism (Hypothyroidism), accounting for 41.30%, hyperthyroidism was 3 cases (6.52%) %, Subclinical hypothyroidism in 12 cases, accounting for 26.09%, subclinical hyperthyroidism in 1 case, accounting for 2.17%. The positive rates of TPOAb Ig G2 subtype before and after antiviral therapy were significantly higher than those in the normal group (P = 0.005 and 0.036, respectively). The positive rates of TPA Ig Ig, Ig G3 and Ig G4 in normal and abnormal groups were No statistical significance (P> 0.05). CONCLUSIONS: The detection of TPOAb Ig G2 subtype in patients with TPOAb-positive CHC before the treatment with interferon can predict abnormal thyroid function in antiviral therapy, especially the possibility of hypothyroidism and subclinical hypothyroidism, which may be helpful to guide Clinical monitoring and timely detection of thyroid dysfunction.