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住院COVID-19患者的非甲状腺疾病综合征和甲状腺自身免疫:一项回顾性研究
Ewa Kozłowska1, Milena Małecka-Giełdowska1,2, Olga Ciepiela1,2
1Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland.
Journal of clinical medicine
|October 16, 2025
概括
非甲状腺疾病综合征 (NTIS) 和甲状腺自身免疫在住院COVID-19患者中很常见,这表明疾病的严重程度和免疫活性. 甲状腺检测,包括FT3/RT3比率和自身抗体,可能具有预后价值.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 甲状腺功能障碍,包括非甲状腺疾病综合征 (NTIS),经常在危急病患者中观察到,并且在COVID-19中报告过.
- NTIS的特点是低的自由三甲状腺素 (fT3) 与正常或低的甲状腺刺激激素 (TSH) 和自由甲状腺素 (fT4).
- 甲状腺激素变化,自身免疫和COVID-19严重程度之间的相互作用需要进一步调查.
研究的目的:
- 调查COVID-19患者甲状腺功能障碍和自身免疫的流行情况.
- 为了比较重症监护室 (ICU) 和大病房COVID-19患者之间的甲状腺功能和自身抗体状态,以及一个非感染的对照组.
- 评估甲状腺变化,自身免疫和COVID-19中的疾病严重程度之间的关系.
主要方法:
- 对276名住院COVID-19患者 (138名ICU,138名普通病房) 和110名非感染控制者的回顾性研究.
- 测量血清TSH,ft3,ft4和逆T3 (rT3) 的测量.
- 对抗甲状腺过氧化酶 (anti-TPO),抗甲状腺球蛋白 (anti-Tg) 和甲状腺蛋白受体抗体 (TRAb) 的评估.
主要成果:
- 在ICU患者中,NTIS存在于44.2%,非ICU患者中18.1%,对照组中1.8%.
- 与非ICU患者和对照人群相比,ICU患者的fT3/rT3比率明显较低.
- 甲状腺自身抗体,特别是抗TPO,在COVID-19患者中更为普遍,这表明SARS-CoV-2诱导的免疫激活.
结论:
- 在住院COVID-19患者中,NTIS和甲状腺自身免疫是常见的,与疾病严重程度相关.
- 甲状腺功能测试,包括fT3/rT3比率,和自身抗体概况 (特别是三重阳性) 可以作为预后标记.
- 在COVID-19患者的常规甲状腺查可以提供有价值的预后见解.
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