自身免疫性甲状腺疾病合并远端肾小管性酸中毒发病机制研究

采用间接免疫荧光法对自身免疫性甲状腺疾病 ( Autoimmune thyroiddisease,AITD)合并远端肾小管性酸中毒 ( Distal renal tubular acidosis,DRTA) 30例及自身免疫性甲状腺疾病不合并远端肾小管性酸中毒 30例患者进行肾小管抗体测定 ,并与健康人比较。结果显示 :合并远端肾小管性酸中毒组有 9例肾小管抗体阳性 ,阳性率为 30 % ,该组甲状腺球蛋白抗体及甲状腺微粒体抗体浓度明显高于不合并远端肾小管性酸中毒组及健康组 ,后两组肾小管抗体均阴性。提示部分肾小管抗体可能来自甲状腺的自身抗体 ,它们具有免疫交叉反应。其抗原可能系肾小管细胞胞浆 ,这种反应损坏肾小管而导致了肾小管性酸中毒。

STUDY ON PATHOGENESIS OF AUTOIMMUNE THYROID DISEASE WITH DISTAL TUBULAR ACIDOSIS

The antibody to the renal tubule in 30 cases of autoimmune thyroid disease with distal tubular acidosis and 30 cases of autoimmune thyroid disease without distal tubular acidosis was measured with indirect immunofluorescence and compared with that of healthy people.The results showed that the antibody was positive in 9 of 30 cases of autoimmune thyroid disease with distal tubular acidosis. The incidence rate was 30%. The concentration of thyroglobulin antibody and thyroid microsome antibody were higher than those of patients without distal tubular acidosis and healthy people, and the antibody to the tubule was negative in the later two groups.It indicates that some antibody to the tubule probably is from autoantibody to tyroid and both antibodies react with each other immunely.The antigen possibly is cytoplasm of the tubular cell,the immune reaction damages the tubule and then causes the distal tubular acidosis.