Pearce Elizabeth N, Bogazzi Fausto, Martino Enio, Brogioni Sandra, Pardini Enia, Pellegrini Giovanni, Parkes Arthur B, Lazarus John H, Pinchera Aldo, Braverman Lewis E
Section of Endocrinology, Diabetes, and Nutrition, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
Thyroid. 2003 Jul;13(7):643-8. doi: 10.1089/105072503322239989.
C-reactive protein (CRP) levels have not been routinely used to diagnose thyroid disease, although many thyroid conditions involve inflammation. This study was intended to determine whether CRP levels could differentiate between inflammatory and noninflammatory thyroid conditions, especially between type II inflammatory amiodarone-induced thyrotoxicosis (AIT) and type I iodine-induced AIT. Serum high-sensitivity CRP levels were measured in 100 euthyroid controls (7 taking amiodarone) and 353 patients with one of the following thyroid conditions: AIT, subacute thyroiditis, toxic diffuse goiter, nodular goiter, Hashimoto's thyroiditis, shortterm hypothyroidism, or postpartum thyroiditis. No patients with nontoxic multinodular goiter (n = 34), toxic nodular goiter (n = 23), or toxic diffuse goiter, either untreated (n = 49) or euthyroid while taking methimazole (n = 33), had positive CRP levels (>10 mg/L). The occurrence of positive CRP levels among patients with Hashimoto's thyroiditis (n = 35), short-term hypothyroidism (n = 38), and postpartum thyroiditis (n = 70) did not differ significantly from controls. The occurrence of positive CRP values did not differ significantly between patients with type I and type II AIT and controls. Six of 7 patients (86%) with untreated subacute thyroiditis had positive CRP levels (p < 0.00001). These results indicate that there is only a limited role for measurement of CRP levels in the diagnosis of thyroid diseases other than subacute thyroiditis.
尽管许多甲状腺疾病都涉及炎症，但C反应蛋白（CRP）水平尚未常规用于诊断甲状腺疾病。本研究旨在确定CRP水平是否能够区分炎症性和非炎症性甲状腺疾病，特别是II型炎症性胺碘酮所致甲状腺毒症（AIT）和I型碘所致AIT。对100名甲状腺功能正常的对照者（7名服用胺碘酮）和353例患有以下甲状腺疾病之一的患者测定了血清高敏CRP水平：AIT、亚急性甲状腺炎、毒性弥漫性甲状腺肿、结节性甲状腺肿、桥本甲状腺炎、短期甲状腺功能减退或产后甲状腺炎。患有非毒性多结节性甲状腺肿（n = 34）、毒性结节性甲状腺肿（n = 23）或毒性弥漫性甲状腺肿的患者，无论是未治疗的（n = 49）还是服用甲巯咪唑时甲状腺功能正常的（n = 33），均无CRP水平阳性（>10 mg/L）。桥本甲状腺炎患者（n = 35）、短期甲状腺功能减退患者（n = 38）和产后甲状腺炎患者（n = 70）中CRP水平阳性的发生率与对照者相比无显著差异。I型和II型AIT患者与对照者之间CRP阳性值的发生率无显著差异。7例未治疗的亚急性甲状腺炎患者中有6例（86%）CRP水平阳性（p < 0.00001）。这些结果表明，CRP水平测定在诊断除亚急性甲状腺炎以外的甲状腺疾病中作用有限。
