慢性扁桃体炎患者甲状腺自身免疫状态的临床分析

王永森; 张朝赞; 尹静; 戴秀丽; 周丽娜; 顾世民

doi:10.12025/j.issn.1008-6358.2017.20170613

摘要: 目的：检测反复发作的慢性扁桃体炎患者的甲状腺自身抗体，分析甲状腺自身免疫性疾病患病率，探讨慢性扁桃体炎与甲状腺自身免疫的关系。方法：以慢性扁桃体炎患者女122例（炎症女组）、男105例（炎症男组）为研究对象，以同龄、无慢性扁桃体炎体检者女172例（非炎症女组）、男146例（非炎症男组）为对照组，进行回顾性分析。检测并对比分析炎症男、女组与相应非炎症组之间甲状腺球蛋白抗体（thyroglobulin antibody, TgAb）、甲状腺过氧化物酶抗体（thyroid peroxidase antibody, TPOAb）、促甲状腺激素受体抗体（thyroid-stimulating hormone receptor antibody, TRAb）等甲状腺自身抗体阳性率的不同；进一步对比分析炎症男、女组与相应非炎症组之间慢性淋巴细胞性甲状腺炎（chronic lymphocytic thyroiditis, CLT）、毒性弥漫性甲状腺肿（Graves disease, GD）等甲状腺自身免疫性疾病患病率的不同；对比分析炎症男、女组与相应非炎症组之间甲状腺功能异常率的不同。结果：炎症男、女组TgAb、TPOAb的阳性率（男：14.3%，30.5%；女：30.3%，40.2%）明显高于相应非炎症组（P<0.05）；炎症男、女组TRAb的阳性率（2.9%、4.1%）与相应非炎症组比较差异无统计学意义。炎症男、女组CLT患病率（16.2%、25.4%）明显高于相应非炎症组的患病率（P<0.01）；炎症男、女组GD患病率（2.9%、4.1%）与相应非炎症组比较差异无统计学意义。炎症男、女组亚临床甲状腺功能减退（亚甲减）的患病率（21.9%、27.9%）均明显高于相应非炎症组（P<0.01）；炎症女组临床甲状腺功能减退（甲减）的患病率（6.6%）明显高于非炎症女组（P<0.05）。炎症男、女组亚临床甲状腺功能亢进（亚甲亢）、临床甲状腺功能亢进（甲亢）的患病率及炎症男组甲减的患病率与相应非炎症组比较差异均无统计学意义。结论：慢性扁桃体炎患者甲状腺部分自身抗体阳性率、CLT患病率、甲状腺功能异常率均明显增高，提示慢性扁桃体炎反复发作与甲状腺自身免疫损伤有相关性。

Abstract: Objective：To investigate the relationship between chronic tonsillitis and thyroid autoimmunity by detecting thyroid autoantibodies and analyzing the morbidity of autoimmune thyroid diseases (AITD) in patients with recurrent chronic tonsillitis. Methods：122 female patients with chronic tonsillitis (female inflammatory group) and 105 male patients (male inflammatory group) were selected as the research objects. 172 female patients (female non-inflammatory group) and 146 male patients (male non-inflammatory group) of the same age and with no chronic tonsillitis were selected as the control group. Retrospective analysis was performed. The differences of the positive rates of thyroid autoantibodies including thyroglobulin antibodies (TgAb), thyroid peroxidase antibodies (TPOAb), and thyrotropin receptor antibody (TRAb) between the two groups were detected and comparatively analyzed. The morbidity of autoimmune thyroid diseases such as chronic lymphocytic thyroiditis (CLT), Graves disease (GD) and other autoimmune diseases was further analyzed and comparatively analyzed between the two groups. The difference of abnormal thyroid function between the two groups was compared.Results：The positive rates of TgAb and TPOAb in male and female inflammatory groups (male: 14.3%, 30.5%; female: 30.3%, 40.2%) were significantly higher than those of the non-inflammatory group (P<0.05); the positive rates of TRAb in male and female inflammatory groups (male: 2.9%; woman: 4.1%) were not significantly different from that of the non-inflammatory group. The prevalence of CLT in male and female inflammatory patients (male: 16.2%; female, 25.4%) was significantly higher than that in the corresponding non-inflammatory group (P<0.01); the prevalence of GD in the male and female inflammatory patients (male: 2.9%; female: 4.1%) was not significantly different from that in the non-inflammatory group.The prevalence of subclinical hypothyroidism in the male and female inflammatory patients (male: 21.9%; female: 27.9%) was significantly higher than that in the non-inflammatory group (P<0.01). The prevalence of hypothyroidism in the female inflammatory group (6.6%) was significantly higher than that in the female non-inflammatory group (P<0.05). The prevalence of subclinical hyperthyroidism and clinical hyperthyroidism in male and female inflammatory patients and the prevalence of hypothyroidism in the male group were not significantly different from those in the non-inflammatory group.Conclusions：The positive rate of thyroid autoantibodies, the prevalence of CLT and the abnormal rate of thyroid function in patients with chronic tonsillitis are significantly higher. Chronic tonsillitis may be a risk factor for autoimmune thyroid damage.