摘要目的 了解Turner综合征(TS)患儿自身免疫性甲状腺抗体(TAA)的变化特点及其与甲状腺功能、年龄、核型、血脂代谢异常的关系.方法 收集2007年7月至2015年7月中山大学孙逸仙纪念医院32例经染色体核型分析确诊的TS患儿临床资料,检测血清TAA,将患儿分为TAA阳性组与TAA阴性组,对2组患儿的甲状腺功能、年龄、染色体核型和血脂情况进行对比分析.结果 TAA阳性患儿23例(23/32例,71.88％),其中甲状腺功能异常9例(9/23例,39.13％);TAA阴性患儿9例(9/32例,28.12％),其中甲状腺功能异常3例(3/9例,33.33％).TAA阳性组与TAA阴性组年龄分别为(12.08±2.90)岁和(8.89±4.17)岁,2组间比较差异有统计学意义(t=101.500,P=0.047).按年龄分为0～5岁、>5～10岁、>10～15岁和>15岁 4组,各年龄组TAA阳性率分别为25.00％(1/4例)、75.00％(6/8例)、82.35％(14/17例)和66.67％(2/3例).32例TS患儿检测脂代谢20例,出现脂代谢紊乱者11例(11/20例,55.00％),其中TAA阳性患儿9例(81.82％),TAA阴性患儿2例(18.18％),2组脂代谢紊乱发病率比较差异有统计学意义(x2=4.848,P=0.028);TS各种核型之间与TAA阳性率差异无统计学意义(x2=4.246,P=0.120).结论 TS合并TAA阳性患儿易出现甲状腺功能异常及脂代谢紊乱,应定期监测TAA及甲状腺功能,必要时随诊脂代谢相关检查.

abstractsObjective To investigate the changes of thyroid autoantibody(TAA)in children with Turner syndrome(TS),and its association between TAA and thyroid dysfunction,age,karyotype and dyslipidaemia.Methods Thirty-two patients with TS diagnosed by chromosome analysis hospitalized at Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University from July 2007 to July 2015 were divided into 2 groups based on TAA-positive or TAA-negative,then the thyroid dysfunction,the age,the karyotype and the lipid metabolism were compared between 2 groups.Results Of the 23 cases of TAA-positive girls(23/32 cases,71.88％),9 girls(39.13％)suffered from thyroid dysfunction;of the 9 cases of TAA-negative girls(9/32 cases,28.12％),3 girls(33.33％)had thyroid dysfunction.As compared with the girls in TAA-negative group,the age in TAA-positive group was significantly higher[(12.08±2.90)years old vs.(8.89±4.17)years old],and the difference was significant(t=101.500,P=0.047).The patients were divided into 4 age groups:0-5 years old,>5-10 years old,>10-15 years old and >15 years old;the rates with TAA-positive were 25.00％(1/4 cases),75.00％(6/8 cases),82.35％(14/17 cases)and 66.67％(2/3 cases)respectively.Twenty patients received the lipid metabolism test,and 11 cases(11/20 cases,55.00％)of them suffered from dyslipidaemia,9 cases of them were TAA-positive(9/11 cases,81.82％),and 2 cases were TAA-negative(2/11 cases,18.18％).The differences in the prevalence of dyslipidaemia between the 2 groups were significant(x2=4.848,P=0.028).There was no significant difference in the numbers of TAA-positive cases among different karyotypes(x2 =4.246,P=0.120).Conclusions Patients with TS are prone to suffer from thyroid dysfunction and dyslipidaemia.Timely detection of TAA and thyroid function is recommended,as well as the lipid metabolism if necessary.