摘要目的 研究难治性哮喘患者血浆甲状腺激素和同型半胱氨酸(Hcy)水平,探讨其在难治性哮喘中的表达改变及相互关系.方法 采集27例难治性哮喘患者、46例普通哮喘患者和30例健康对照组血浆标本,采用电化学发光法测定血浆甲状腺激素水平,采用反相高效液相色谱荧光检测法测定Hcy水平,并进行相关性分析.结果 难治性哮喘患者组血浆三碘甲状腺原氨酸(TT3)(1.22±0.27)nmol/L、游离三碘甲状腺原氨酸(FT3) (2.26±0.66) pmol/L、游离甲状腺素(FT4)(9.87±2.75) pmol/L水平明显低于普通哮喘患者组(P ＜0.01,P＜0.01,P＜0.05)和健康对照组(P值均＜0.01),普通哮喘患者组血清TT3、FT3水平均低于健康对照组(P值均＜0.05),难治性哮喘患者组、普通哮喘患者组、健康对照组各组间TT4、TSH水平差异无统计学意义.难治性哮喘患者组血浆Hcy水平(19.34±7.24) μmol/L明显高于普通哮喘组(P＜0.05)及健康对照组(P＜0.01),普通哮喘患者组Hcy水平(14.25±4.76) μmol/L和健康对照组(12.56±5.23) μmol/L相比差异无统计学意义.相关分析表明,难治性哮喘患者Hcy水平分别与TT3、FT3水平呈负相关(r=-0.334,P＜0.05;r=-0.403,P＜0.05).结论 难治性哮喘患者血浆甲状腺激素及Hcy水平改变,两者可能相互作用,共同参与影响难治性哮喘患者疾病进展.

abstractsObjective To investigate the levels and possible levels and associations of thyroid hormones and homocysteine (Hcy) in difficult-to-treat asthma patients.Methods Plasma samples were collected from 27 difficult-to-treat asthma patients,46 asthma patients and 30 healthy controls.The levels of plasma thyroid hormones were detected by electrochemiluminescence immunoassay,the level of Hcy was detected by fluorescence detection method of reversed phase high performance liquid chromatography.Linear correlation analysis was used to analyze the correlationship between them.Results The levels of plasma total triiodothyronine (TT3) (1.22 ± 0.27) nmol/L,free triiodothyronine (FT3) (2.26±0.66) pmol/L and free thyroxine (FT4)(9.87 ±2.75) pmol/L were significantly lower in difficult-to-treat asthma patients compared to asthma patients (P ＜ 0.01,P ＜ 0.01,P ＜ 0.05) and healthy controls(P ＜0.01).The levels of plasma TT3,FT3 were lower in asthma patients compared to healthy controls (P ＜0.05).No significant difference was found of TT4 and TSH in each group.Hcy level (19.34±7.24) μmol/L was higher in difficult-to-treat asthma patients compared to asthma patients (P ＜0.05) and healthy controls (P ＜0.01).However,there was no significant difference of Hcy level between asthma patients (14.25 ± 4.76) μmol/L and healthy controls (12.56 ± 5.23) μmol/L.In addition,the level of Hcy was negatively correlated with TT3 and FT3 levels respectively (r =-0.334,P ＜ 0.05;r =-0.403,P ＜ 0.05).Conclusions Strong associations were found between thyroid hormones and Hcy in difficult-to-treat asthma patients,which participated in the pathogenesis of difficult-to-treat asthma patients.