[1]郭永华,陈 敏,黄惠英,等.甲状腺抗体阳性患者发生脑病的随访观察[J].医学信息,2020,33(13):137-139.[doi:10.3969/j.issn.1006-1959.2020.13.040]
　GUO Yong-hua,CHEN Min,HUANG Hui-ying,et al.Follow-up Observation of Encephalopathy in Patients with Positive Thyroid Antibody[J].Medical Information,2020,33(13):137-139.[doi:10.3969/j.issn.1006-1959.2020.13.040]
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甲状腺抗体阳性患者发生脑病的随访观察()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年13期
页码:
137-139
栏目:
调查分析
出版日期:
2020-07-01

文章信息/Info

Title:
Follow-up Observation of Encephalopathy in Patients with Positive Thyroid Antibody
文章编号:
1006-1959（2020）13-0137-03
作者:
郭永华; 陈 敏; 黄惠英; 等
（1.乐山市人民医院神经内科，四川 乐山 614000；2.四川省第五人民医院检验科，四川 成都 610041）
Author(s):
GUO Yong-hua; CHEN Min; HUANG Hui-ying; et al
(1.Department of Neurology,Peopl’s Hospital of Leshan,Leshan 614000,Sichuan,China;2.Department of Laboratory Medicine,the Fifth People’s Hospital of Sichuan Province,Chengdu 610041,Sichuan,China)
关键词:
甲状腺球蛋白抗体; 甲状腺过氧化物酶抗体; 桥本脑病
Keywords:
Thyroglobulin antibody; Thyroid peroxidase antibody; Hashimoto encephalopathy
分类号:
R747.9；R581
DOI:
10.3969/j.issn.1006-1959.2020.13.040
文献标志码:
A
摘要:
目的 对甲状腺抗体阳性人群进行随访，观察其是否发生桥本脑病的情况，探讨甲状腺抗体（甲状腺过氧化物酶抗体TPOAb和甲状腺球蛋白抗体TGAb）做为诊断桥本脑病（HE）特异性抗体的可行性。方法 连续收集2016年4月~2017年5月乐山市人民医院甲状腺功能正常且无脑病人群的病历资料，随访31~44个月，观察甲状腺抗体阳性和阴性人群发生脑病情况。结果 本研究纳入患者2971例，男922例，女2049例。绝大部分年龄段的甲状腺抗体阳性比例变化不明显，仅有极少部分转阴或转阳。甲状腺抗体阳性者发生脑血管病比例高于阴性者，差异有统计学意义（P＜0.05），但发生脑血管病的患者均有明确的责任血管，1例甲状腺抗体阴性者患病毒性脑炎，未使用激素治疗，仅抗病毒治疗后好转，均不符合HE；甲状腺抗体阳性者未发生脑炎。结论 甲状腺抗体可长期存在，甲状腺抗体阳性者可能较阴性者更易发生脑血管病，未观察到甲状腺抗体阳性者发生HE。甲状腺抗体可能并非HE的致病抗体，其做为HE诊断指标之一有待斟酌。
Abstract:
Objective To follow up the thyroid antibody positive population to observe whether Hashimoto encephalopathy occurs, and to explore thyroid antibodies (thyroid peroxidase antibody TPOAb and thyroglobulin antibody TGAb) as specific antibodies for diagnosis of Hashimoto encephalopathy (HE) feasibility.Methods The medical records of patients with normal thyroid function and brainless patients in Leshan City People’s Hospital from April 2016 to May 2017 were collected continuously and followed up for 31 to 44 months to observe the occurrence of encephalopathy in people with positive and negative thyroid antibodies.Results This study included 2971 patients, 922 males and 2049 females. The positive proportion of thyroid antibody in most age groups does not change significantly, and only a few of them turn negative or positive. Thyroid antibody-positive patients had a higher rate of cerebrovascular disease than negative patients, the difference was statistically significant(P＜0.05),but patients with cerebrovascular disease had clear responsible blood vessels, and 1 case of thyroid antibody-negative patients had viral encephalitis,without hormone therapy, only improved after antiviral treatment, did not meet HE; thyroid antibody positive patients did not develop encephalitis.Conclusion Thyroid antibodies can exist for a long time. Patients with positive thyroid antibodies may be more likely to develop cerebrovascular disease than those with negative thyroid antibodies. HEs were not observed in those with positive thyroid antibodies. Thyroid antibody may not be the pathogenic antibody of HE, and it is one of the diagnostic indicators of HE to be considered.

参考文献/References:

[1]吴雅婷,刘爱华.桥本脑病17例临床分析[J].临床神经病学杂志,2018,31(5):368-371. [2]郭永华,李亚琴,刘旭,等.无神经系统疾病人群甲状腺抗体升高情况调查[J].解放军医学杂志,2018,43(7):608-613.[3]杜一平,范源,刘涛.桥本脑病的临床诊治研究进展[J].昆明医科大学学报,2020,41(2):1-6.[4]Graus F,Titulaer MJ,Balu R,et al.A clinical approach to diagnosis of autoimmune encephalitis[J].Lancet Neurol,2016,15(4):391-404.[5]Li Y,Teng D,Shan Z,et al.Antithyroperoxidase and antithyroglobulin antibodies in a five-year follow-up survey of populations with different iodine intakes[J].J Clin Endocrinol Metab,2008,93(5):1751-1757.[6]温小恒,张彪,张葵,等.健康体检人群甲状腺抗体与甲状腺功能相关性分析[J].中国医药导报,2015,12(25):69-72,77.[7]Kirshner HS.Hashimoto’s encephalopathy:a brief review[J].Curr Neurol Neurosci Rep,2014,14(9):476.

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更新日期/Last Update: 1900-01-01