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目的探讨不同型别糖尿病患者甲状腺自身抗体及血清中硒水平的变化及其相关影响因素。方法选取糖尿病患者50例(2型糖尿病患者30例和1型糖尿病患者20例)为实验组,健康体检者50例为对照组,采用化学发光法分别测定三组的抗甲状腺过氧化酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TGAb)水平,采用竞争性的酶联免疫分析法检测促甲状腺激素受体抗体(TRAb)水平。采用原子吸收光谱法测定各组血清硒的水平,观察各组间的差异及血清硒与甲状腺自身抗体的相关性,并进行统计学分析。结果糖尿病组的TPOAb、TRAb、TGAb水平显著高于健康体检组(t=3.246、4.017、3.267,P<0.05),血清硒水平则显著低于健康体检组(t=-6.794,P<0.05)。而2型糖尿病TGAb和血清硒水平显著高于1型糖尿病患者(t=2.143、3.012,P<0.05)。在2型糖尿病患者中,血清硒水平与TRAb呈负线性相关(r=-0.767,P<0.05)。结论糖尿病患者甲状腺自身抗体及血清硒水平均已发生改变,2型糖尿病患者TRAb水平与血清硒水平高度负线性相关。
Objective To investigate the changes of serum thyroid autoantibodies and selenium levels in patients with different types of diabetes mellitus and its related factors. Methods Fifty patients with diabetes mellitus (30 patients with type 2 diabetes mellitus and 20 patients with type 1 diabetes mellitus) were selected as experimental group and 50 healthy subjects as control group. The levels of anti-thyroid peroxidase antibody TPOAb) and anti-thyroglobulin antibody (TGAb) levels were measured by competitive enzyme-linked immunosorbent assay for thyrotropin receptor antibody (TRAb) levels. The levels of serum selenium in each group were determined by atomic absorption spectrometry. The differences between the groups and the correlation between serum selenium and thyroid autoantibodies were observed and statistically analyzed. Results The levels of serum TPOAb, TRAb and TGAb in diabetic group were significantly higher than those in healthy group (t = 3.246, 4.017, 3.267, P <0.05) . TGAb and selenium levels in type 2 diabetes were significantly higher than those in type 1 diabetes (t = 2.143, 3.012, P <0.05). In patients with type 2 diabetes, serum selenium levels were negatively correlated with TRAb (r = -0.767, P <0.05). Conclusion The levels of thyroid autoantibodies and serum selenium in diabetic patients have changed. The level of TRAb in type 2 diabetic patients is highly negatively correlated with serum selenium level.