翻译者：赵倩倩，医院临床免疫科
研究目的
本研究旨在评价类风湿关节炎患者甲状腺功能及抗甲状腺抗体发生率及临床价值。
研究方法
这项研究，纳入70例活动性RA患者，其中男9例，女61例，平均年龄47岁（范围15-77岁）进行分析。测定了抗甲状腺氧化物酶（TPOAb）和抗甲状腺球蛋白抗体（TgAb）。并测定FT4和FT3和促甲状腺激素(TSH)血清水平。同时将甲状腺功能与RF、ANA、血沉、CRP、关节肿胀、压痛关节数及抗CCP抗体相关性进行研究。
研究结果
RA患者26例（37％）抗甲状腺过氧化物酶（TPOAb）阳性，抗甲状腺球蛋白抗体(TgAb)阳性16例（23％）。5例（7.1％）TSH患者水平略有升高。TSH水平的升高，FT4正常3例(4.2%)。TSH水平升高，FT4减低有2例(2.8%)。1例（1.5％）TSH血清值低正常FT4。
研究结论
甲状腺功能异常与RF、ANA、血沉、CRP、关节肿胀、压痛关节数及抗CCP抗体无显著相关性。
参考文献：Anti-thyroidantibodiesandthyroiddysfunctioninrheumatoidarthritis:Prevalenceandclinicalvalue
Objectives:Theaimofthisstudywastoassessthyroidfunctionaswellastheprevalenceandclinicalvalueofanti-thyroidantibodiesinpatientswithrheumatoidarthritis(RA).
Methods:SeventypatientswithactiveRA(ACRcriteria),9malesand61females,meanage47years(range15–77)wereanalyzed.Anti-thyroperoxidase(TPOAb)andanti-thyroglobulinantibodies(TgAb)weretestedusingradioimmunoassay.Freethyroxine(FT4)andfreetriiodothyronine(FT3)andthyroid-stimulatinghormone(TSH)serumlevelsweremeasuredusingelectro-immunochemiluminescence(ECLIA,ElecsysRoche).Clinicalvariables,includingtenderandswollenjointcount,erythrocytesedimentationrate(ESR),C-reactiveprotein(CRP),rheumatoidfactor(RF),anti-cycliccitrullinatedpeptideantibody(anti-CCP)andantinuclearantibodies(ANA)werealsoevaluated.StatisticswereperformedbytheSPSSstatisticalsoftwareforWindows.Results:Twenty-sixpatients(37%)withRAwerepositiveforTPOAband16(23%)forTgAb.In5(7.1%)patientsTSHlevelwasslightlyelevated,rangingbetween4.52and15.65UI/ml.TheincreaseofTSHlevelswasassociatedwithnormaFT4in3cases(4.2%)andwithreducedFT4in2cases(2.8%).Onepatient(1.5%)hadlowTSHserumvaluealongwithnormalFT4.Nodifferencesinclinicalandserologicaldatabetweenanti-thyroidpositiveandnegativepatientswereobserved.Conclusion:Ourstudyshowsanincreasedprevalenceofanti-thyroidantibodiesinRApatientswithalowprevalenceofhormonalalterations.However,anti-thyroidantibodiesdonotseemtoidentifyanypeculiarRAphenotype。
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