| Objective:The study aims to analyze the change of serum thyroid hormone levels in HIV/AIDS patients and nomal people,explore whether thyroid function is correlated with CD4+T level and albumin level in HIV/AIDS patients,and study the relationship between thyroid hormone level and prognosis of HIV/AIDS patients.Methods:110 patients with HIV/AIDS included in the study were taken as the experimental group,and biochemical indexes such as CD4+T,thyroid function(FT3、FT4、TSH),lung CT,blood routine,and liver function were detected in all the patients in the experimental group.According to CD4+T level,it is divided into two groups,one group is more than or equal to 200/μl,the other group is less than 200/μl and patients were divided into survival group and death group according to their survival status.Meanwhile,49 healthy subjects in the same period were included as the control group,and their thyroid function,CD4+T and other indicators were detected.The levels of CD4+T,FT3,FT4 and TSH in the experimental group were compared with the healthy control group,and the differences of above indicators in the survival group and the death group were studied,to analyze whether CD4+T,FT3,FT4 and TSH were correlated with each other in HIV/AIDS patients.SPSS17.0 software was used for statistical analysis.Results:1、38 patients,accounting for 34.5% of the total cases of HIV/AIDS,had one or more abnormal thyroid hormone secretions,among which 18 cases had decreased FT3,14 cases had decreased FT4,3 cases had increased FT4,6 cases had decreased TSH,and 15 cases had increased TSH.Among the 38 patients with HIV/AIDS,3 cases clinically diagnosed hypothyroidism,12 cases subclinical hypothyroidism,2 cases hyperthyroidism and 4 cases subclinical hyperthyroidism.2、The levels of FT3,FT4,TSH and CD4+T in the normal control group were 3.08±0.45 pg/ml,0.94±0.20 ng/dl,2.24±0.93 μIU/ml and 765.9±200.1/μl,respectively.The levels of FT3,FT4,TSH and CD4+T in the CD4+T <200/μl group were 2.44±0.74 pg/ml,0.80 ±0.28 ng/dl,2.70±1.60 μIU/ml and 81.2±53.4/μl,respectively.The levels of FT3,FT4,TSH and CD4+T in the CD4+T ≥200/μl group were 3.00±0.86 pg/ml,0.93±0.25 ng/dl,2.70±1.41 μIU/ml and 378.2±159.4/μl,respectively.3、There was a positive correlation between FT3 and CD4+T,FT4 and albumin(the correlation coefficients were 0.320,0.305,0.528 respectively).FT4 was positively correlated with CD4+T(the correlation coefficients were 0.266).The levels of FT3,FT4,TSH and CD4+T in the death group were: 1.86±0.83 pg/ml,0.77±0.43 ng/dl,2.27±2.01 μIU/m1 and 103.6±116.6/μl.The levels of FT3,FT4,TSH and CD4+T in the survival group were: 2.79±0.80 pg/ml,0.87±0.25 ng/dl,2.75±1.43 μIU/ml and 225.6±189.1/μl.4、FT3,FT4 and TSH levels of 53 patients before and after 12 months of antiviral treatment were 2.52±0.75 pg/ml and 2.58±0.48 pg/ml,0.82±0.28 ng/dl and 0.86±0.27 ng/dl;2.71±1.56 μIU/ml and 2.10±1.00 μIU/ml,respectively.and the FT3,FT4 and TSH levels of 19 patients with thyroid dysfunction before and after 12 months of treatment were 2.24±0.97 pg/ml and 2.52±0.57 pg/ml,0.75±0.39 ng/dl and 0.82±0.29 ng/dl;3.63±1.99 μIU/ml and 2.52±1.35 μIU/ml,respectively.Conclusions:Thyroid dysfunction exists in HIV/AIDS patients,and FT3 decline and subclinical hypothyroidism are the main causes.Low FT3(lower than normal level)may mean poor prognosis,and thyroid dysfunction will be improved after active anti-hiv treatment. |
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