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甲状腺功能障碍对血液学参数的影响:病例对照研究。

Effects of thyroid dysfunction on hematological parameters: Case controlled study.

作者信息

Ahmed Sawer Sabri, Mohammed Ayad Ahmad

机构信息

Department of Medial Laboratory Technology, Shekhan Technical College of Health, Duhok Polytechnic University, Duhok, Kurdistan Region, Iraq.

Department of Surgery, College of Medicine, University of Duhok, DUHOK, Kurdistan Region, Iraq.

出版信息

Ann Med Surg (Lond). 2020 Jul 11;57:52-55. doi: 10.1016/j.amsu.2020.07.008. eCollection 2020 Sep.

Abstract

INTRODUCTION

The thyroid gland has a very important role in hematopoiesis, blood disorders are frequently seen in patients with thyroid disorders. Thyroid hormones have direct effect on blood parameters by stimulating erythrocytes precursors and indirectly by enhancing erythropoietin production.

PATIENTS AND METHODS

This is a case-control study which included 300 subjects who were grouped to 3 equal groups as a control, hypothyroidism, and hyperthyroidism groups. Patients with inherited or acquired red cell abnormalities, those receiving treatment for thyroid disorder or anemia, patient with chronic diseases, aged <12 years, pregnant ladies and patients unwilling to participate in the study were excluded.

RESULTS

The mean age of patients is 40.72 years, and females constituted 60.7% of cases. The analyses showed a significant difference the RBC, HB, MCV, MCHC, RDW, and WBC (P values 0.000, 0.000, 0.001, 0.012.0.002, and 0.027) respectively, while platelets showed no significant correlation (P value 0.08). The univariate analyses showed that RBC, the HB, and the WBC were the most severely affected parameters (Sig. 0.000, 0.000, and 0.005) respectively.

CONCLUSION

The study concluded that females are more affected by thyroid disorders than males and the peak age is at the forties, thyroid dysfunction affect all blood parameters except platelets.The follow up of patients with thyroid disorders should include the complete blood count and patients diagnosed with anemia should be evaluated for thyroid disorders before iron therapy. Cases of anemia that resist treatment should be investigated for the possibility of thyroid dysfunction.

摘要

引言

甲状腺在造血过程中起着非常重要的作用,甲状腺疾病患者经常出现血液系统紊乱。甲状腺激素通过刺激红细胞前体直接影响血液参数,并通过增强促红细胞生成素的产生间接影响血液参数。

患者与方法

这是一项病例对照研究,纳入300名受试者,分为对照组、甲状腺功能减退组和甲状腺功能亢进组,每组100人。排除患有遗传性或获得性红细胞异常的患者、正在接受甲状腺疾病或贫血治疗的患者、患有慢性疾病的患者、年龄小于12岁的患者、孕妇以及不愿参与研究的患者。

结果

患者的平均年龄为40.72岁,女性占病例的60.7%。分析显示,红细胞(RBC)、血红蛋白(HB)、平均红细胞体积(MCV)、平均红细胞血红蛋白浓度(MCHC)、红细胞分布宽度(RDW)和白细胞(WBC)分别存在显著差异(P值分别为0.000、0.000、0.001、0.012、0.002和0.027),而血小板无显著相关性(P值为0.08)。单因素分析显示,红细胞、血红蛋白和白细胞受影响最为严重(显著性分别为0.000、0.000和0.005)。

结论

该研究得出结论,女性比男性更容易受到甲状腺疾病的影响,发病高峰年龄在四十多岁,甲状腺功能障碍会影响除血小板外的所有血液参数。甲状腺疾病患者的随访应包括全血细胞计数,诊断为贫血的患者在进行铁剂治疗前应评估甲状腺疾病。对治疗抵抗的贫血病例应调查是否存在甲状腺功能障碍的可能性。

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