翻译者：赵倩倩，西京医院临床免疫科

目  的：

本研究的目的是评估甲状腺功能以及类风湿关节炎（RA）患者抗甲状腺抗体的流行和临床价值。

方  法：

对70例活动性RA患者（ACR标准），男性9例，女性61例，平均年龄47岁（范围15-77）进行分析。使用放射免疫测定法测试抗甲状腺过氧化物酶（TPOAb）和抗甲状腺球蛋白抗体（TgAb）。使用电免疫化学发光（ECLIA，Elecsys Roche）测量游离甲状腺素（FT4）和游离三碘甲腺原氨酸（FT3）和促甲状腺激素（TSH）血清水平。关节疼痛和肿胀关节计数，红细胞沉降率（ESR），C反应蛋白（CRP），类风湿因子（RF），抗CCP抗体和抗核抗体（ANA)也被评估。统计数据由Windows的SPSS统计软件执行。

结  果：

26例RA患者（37％）TPOAb阳性，TgAb阳性16例（23％）。在5例（7.1％）患者中，TSH水平略微升高，范围在4.52和15.65 UI / ml之间。TSH水平升高与正常FT4相关3例（4.2％），FT4降低2例（2.8％）。一名患者（1.5％）具有低TSH血清值以及正常FT4。在观察到抗甲状腺阳性和阴性患者之间的临床和血清学数据没有差异。

结  论：

我们的研究显示，RA患者的抗甲状腺抗体的患病率增加。然而，抗甲状腺抗体似乎不能识别任何特殊的RA表型。

参考文献：

Anti-thyroidantibodies and thyroid dysfunction in rheumatoid arthritis: Prevalence andclinical value

Objectives:The aim of this study was to assess thyroid function as well as the prevalenceand clinical value of anti-thyroid antibodies in patients with rheumatoidarthritis (RA).

Methods: Seventypatients with active RA (ACR criteria), 9 males and 61 females, mean age 47years (range 15–77) were analyzed. Anti-thyroperoxidase (TPOAb) andanti-thyroglobulin antibodies (TgAb) were tested using radioimmunoassay. Freethyroxine (FT4) and free triiodothyronine (FT3) and thyroid-stimulating hormone(TSH) serum levels were measured using electro-immunochemiluminescence (ECLIA,Elecsys Roche). Clinical variables, including tender and swollen joint count,erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoidfactor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP) andantinuclear antibodies (ANA) were also evaluated. Statistics were performed by theSPSS statistical software for Windows.

Results:Twenty-six patients (37%) with RA were positive for TPOAb and 16 (23%) forTgAb. In 5 (7.1%) patients TSH level was slightly elevated, ranging between4.52 and 15.65 UI/ml. The increase of TSH levels was associated with normal  FT4 in 3 cases (4.2%) and with reduced FT4 in2 cases (2.8%). One patient (1.5%) had low TSH serum value along with normalFT4. No differences in clinical and serological data between anti-thyroidpositive and negative patients were observed.

Conclusion: Our study shows an increased prevalence ofanti-thyroid antibodies in RA patients with a low prevalence of  hormonal alterations. However, anti-thyroidantibodies do not seem to identify any peculiar RA phenotype。