Relationship between Helicobacter pylori infection and Hashimoto's thyroiditis:A prospective study
- Author:
- No author available
- Journal Title:
- World Chinese Journal of Digestology
- Issue:
- 2
- DOI:
- 10.11569/wcjd.v29.i2.75
- Key Word:
- 幽门螺杆菌;桥本甲状腺炎;甲状腺过氧化物酶抗体;甲状腺球蛋白抗体
Abstract： 背景 桥本甲状腺炎是最常见的自身免疫性疾病,发病率逐年增高,但其病因及发病机制尚不十分清楚.幽门螺杆菌(Helicobacter pylori,H.pylori)感染与桥本甲状腺炎的关系是当前研究热点,但桥本甲状腺炎患者是否应常规筛查并根除H.pylori尚不清楚.目的 探讨H.pylori感染与桥本甲状腺炎的关系,并前瞻性研究桥本甲状腺炎患者根除H.pylori是否获益.为桥本甲状腺炎患者早期是否应积极筛查并根除H.pylori提供参考.方法 随机纳入2018-01/2018-12我院甲状腺工程技术诊疗中心首次就诊的甲功正常的桥本甲状腺炎患者300例,另选取体检中心300例与之匹配的健康人群作为对照组.用化学发光法对两组进行甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)及甲状腺功能的测定.碳13尿素呼气试验检测H.pylori感染．(1)比较H.pylori感染和未感染者桥本甲状腺炎的患病率;(2)桥本甲状腺炎组,比较H.pylori阳性和阴性者TPOAb和TGAb的滴度;(3)将H.pylori阳性的桥本甲状腺炎患者随机分为治疗组和对照组,治疗组予抗H.pylori治疗,对照组不予治疗.治疗结束1mo后复查碳13尿素呼气试验评估根除治疗是否成功.在完成治疗后6 mo、12 mo,再测定两组TPOAb和TGAb滴度并与治疗前比较.结果 H.pylori阳性组桥本甲状腺炎患病率64.67％(194/300),H.pylori阴性组桥本甲状腺炎患病率35.33％(106/300),差异有统计学意义(P＜0.05);桥本甲状腺炎患者中,H.pylori感染者TPOAb和TGAb显著高于H.pylori阴性者.治疗组根除H.pylori后,其TPOAb和TGAb的滴度较治疗前明显下降(P＜0.05),而对照组变化不大.结论 H.pylori感染者桥本甲状腺炎患病率升高.H.pylori感染可使桥本甲状腺炎患者TPOAb和TGAb滴度升高.根除H.pylori可显著降低桥本甲状腺炎患者TPOAb和TGAb滴度.桥本甲状腺炎患者建议早期常规筛查H.pylori感染并积极根除.
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