血管活性肠肽在甲状腺机能亢进症患者中的表达和意义

目的：探讨血管活性肠肽(VIP)与甲亢发生、发展的病理生理过程关系。方法选取2012年6月至2015年6月在湖北医药学院附属人民医院确诊的168例甲亢患者为观察组，60例同时期在我院体检中心体检合格的健康人作为对照组，对所有参与的研究对象进行空腹采静脉血3 mL，并分离血清。检测观察组接受131I治疗前后以及对照组血清游离甲状腺原氨酸(FT3)、离甲状腺素(FT4)及血管活性肠肽(VIP)浓度的变化，并对观察组的VIP水平与甲亢关系做直线回归分析。结果甲亢患者治疗后，FT3、FT4和VIP均下降(5.32±1.40) pmol/L、(15.05±5.42) pmol/L、(184.4±21.7) pmol/L]，与治疗前(10.08±2.34) pmol/L、(29.09±5.46) pmol/L、(421.1±79.6) pmol/L]比较差异均有统计学意义(P<0.05)，与对照组(5.72±1.62) pmol/L、(16.46±3.16) pmol/L、(179.3±16.3) pmol/L]比较差异均无统计学意义(P>0.05)。观察组血清VIP水平与FT3、FT4水平均呈负相关(r=-0.3998、r=-0.3871，P<0.05)。结论 VIP在甲亢患者131I治疗前后的含量有明显变化，解释了甲亢患者出现消化道症状的部分机理。

Expression and significance of vasoactive intestinal peptide in patients with hyperthyroidism

Objective To investigate the relationship between pathophysiological process in pathogenesis of hyperthyroidism and vasoactive intestinal peptide (VIP). Methods A total of 168 patients with hyperthyroidism were enrolled as the observation group, and 60 healthy subjects for physical examination were selected as the control group in our hospital from Jun. 2012 to Jun. 2015. Venous blood (3 mL) was extracted from the subjects, and blood serum was isolated. Changes of serum free thyroid acid (FT3), free thyroxineIndex (FT4) and VIP concentrations in the observation group and control group before and after 131I treatment were detected, and the relationship between VIP level and hyper-thyroidism were analyzed by linear regression. Results Compared with those before treatment, the levels of FT3, FT4 and VIP in the observation group decreased significantly after treatment (5.32 ± 1.40) pmol/L vs (10.08 ± 2.34) pmol/L, (15.05 ± 5.42) pmol/L vs (29.09 ± 5.46) pmol/L, (184.4 ± 21.7) pmol/L vs (421.1 ± 79.6) pmol/L, P<0.05]. The levels after treatment in the observation group showed no statistically significant difference with those of the control group (5.72 ± 1.62) pmol/L, (16.46±3.16) pmol/L, (179.3±16.3) pmol/L, P>0.05]. The serum levels of VIP were negatively correlated with FT3, FT4 in the observation group (r=-0.399 8, r=-0.387 1, P<0.05). Conclusion The content of VIP in patients with hyperthyroidism before and after 131I treatment is significantly changed, which explains the partial mechanism of the digestive tract symptoms in patients with hyperthyroidism.