无活化的SARS-CoV-2疫苗接种不会扰乱格雷夫斯病的临床过程:一项观察性队列研究
Shichen Xu1, Huixin Yu1, Xian Cheng1
1NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China.
Vaccine
|August 6, 2023
概括
无活化的SARS-CoV-2疫苗接种没有对格雷夫斯病 (GD) 甲状腺功能障碍治疗产生负面影响. 接种疫苗的患者表现出新的TSH受体抗体阳性风险降低,甲状腺功能障碍症复发风险没有增加.
科学领域:
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 接种SARS-CoV-2疫苗与甲状腺疾病有关.
- 格雷夫斯病 (GD) 是一种自身免疫性甲状腺过高症.
- 了解疫苗对GD治疗的影响至关重要.
研究的目的:
- 评估无活化SARS-CoV-2疫苗接种对患有格雷夫斯病甲状腺功能过高的患者病程的影响.
- 分析接种疫苗和未接种疫苗的GD患者的甲状腺功能和抗体水平.
主要方法:
- 对651名格雷夫斯病患者 (443名接种疫苗,208名未接种疫苗) 的回顾性研究.
- 对血清中自由三甲状腺素 (fT3),自由甲状腺素 (fT4),甲状腺刺激激素 (TSH) 和TSH受体抗体 (TRAb) 水平的分析.
- 考克斯回归模型用于估计发生TRAb阳性和甲状腺功能障碍复发的风险.
主要成果:
- 在治疗期间,两组的中位数TRAb和ft3水平都下降了.
- 在接种疫苗和未接种疫苗的患者中,ft4水平呈现下降趋势.
- 接种疫苗的患者发生TRAb阳性风险显著降低 (调整HR=0.22).
- 接种疫苗并不是甲状腺功能障碍复发的危险因素 (调整HR=1.20).
- 新诊断的患者实现了类似的缓解率,无论疫苗接种情况如何.
结论:
- 失活的SARS-CoV-2疫苗似乎不会扰乱格雷夫斯病甲状腺功能增强症的治疗过程.
- 接种疫苗可能与在GD患者中发展新的TSH受体抗体阳性风险的降低有关.
- 进一步的研究可能会探索疫苗在自身免疫性甲状腺疾病中的免疫调节作用.
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