摘要
目的探讨亚临床甲状腺功能减退症（亚临床甲减）患者血清C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）及动脉粥样硬化的关系。方法75例亚临床甲减患者根据促甲状腺激素（TSH）水平分为两组：轻度亚临床甲减（TSH5．5～10．0mU/L）组42例，重度亚临床甲减（TSH〉10．0mU／L）组33例；另选取健康体检者或志愿者30例作为对照组。所有受检者均检测三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、TSH、游离甲状腺素（FT4）、游离三碘甲腺原氨酸（FT3）、CRP以及TNF-α，并测量颈动脉内膜．中层厚度（CIMT）。结果轻度亚临床甲减组、重度亚临床甲减组、对照组CIMT分别为（0．88±0．20）、（1．12±0．21）、（0．62±0．21）mm，轻度亚临床甲减组、重度亚临床甲减组CIMT均高于对照组，重度亚临床甲减组CIMT高于轻度亚临床甲减组，差异均有统计学意义（P〈0．01）。三组CRP、TNF-α比较差异无统计学意义（P〉0．05）。轻度亚临床甲减组、重度亚临床甲减组LDL-C[（3．22±0．37）、（3．49±0．38）mmol／L]均高于对照组[（2．48±0．41）mmol/L]，差异有统计学意义（P〈0．01）；对照组、轻度亚临床甲减组HDL-C、TG比较差异无统计学意义（P〉0．05）；与对照组、轻度亚临床甲减组比较，重度亚临床甲减组HDL-C降低[（0．92±0．10）mmol／L比（1．21±0．14）、（1．17±0．11）mmol／L]，TG增高[（1．50±0．49）mmol／L比（1．11±0．53）、（1．27±0．47）mmol／L]，差异有统计学意义（P〈0．01或〈0．05）。TG、LDL-C、TSH、CRP、TNF-α与CIMT呈正相关（r=0．52、0．37、0．48、0．39、0．45，P〈0．05或〈0．01）；n与CIMT呈负相关（r=-0．24，P〈0．05）；HDL-C与CIMT无相关性（r=0．06，P〉0．05）。结论亚临床甲减患者存在血脂代谢紊乱等多种异常，其发生动脉粥样硬化危险性增高，但炎性反应可能不是亚临床甲减并发动脉粥样硬化的主要因素。
Objective To investigate the correlation between serum C-reactive protein （CRP）, tumor necrosis factor-alpha （TNF-α ） and atherosclerosis in patients with subclinical hypothyroidism. Methods Seventy-five patients with subclinical hypothyroidism were divided into two groups according to the level of TSH ：mild group （42 cases） with TSH between 5.5 and 10.0 mU/L and severe group （33 cases） with TSH 〉 10.0 mU/L. Thirty healthy physical examinees or volunteers were selected as control group. TG, LDL-C, HDL-C,TSH, FT4, FT3, CRP, TNF- α and carotid intima-media thickness （CIMT） of all cases were detected and measured. Results CIMT of mild,severe and control groups were （0.88 ± 0.20）, （1.12 ± 0.21 ）, （0.62 ± 0.21 ） ram,respectively. CIMT of mild and severe groups were both significantly higher than that of control group,CIMT of severe group was significantly higher than that of mild group （P 〈 0.01 ）. There were no significant differences of CRP and TNF- α among three groups （P 〉 0.05 ）. LDL-C of mild and severe groups were significantly higher than that of control group [ （ 3.22 ± 0.37 ）, （ 3.49 ± 0.38 ） mmol/L vs. （ 2.48 ± 0.41 ）mmol/L,P 〈 0.01 ]. HDL-C and TG between mild and control groups had no statistical significance （P 〉 0.05）. Compared with control and mild groups,HDL-C of severe group decreased [ （0.92 ± 0.10） mmol/L vs.（1.21 ±0.14）, （1.17 ±0.11） mmol/] and TG increased [（1.50 ±0.49） mmol/L vs.（1.11 ± 0.53 ）, （ 1.27 ± 0.47） mmol/L ] （P 〈 0.01 or 〈 0.05 ）. The levels of TG, LDL-C, TSH, CRP and TNF- α had positive correlation with CIMT （r = 0.52,0.37,0.48,0.39,0.45,P 〈 0.05 or 〈 0.01 ）. FT4 was negatively correlated with CIMT （r =-0.24,P 〈0.05）. HDL-C had no relation with CIMT （r =0.06,P 〉0.05）. Conclusions There are many abnormalities such as metabolism disorder of blood lipid in patients with subclinical hypothyroidism. The risk of atherosclerosis increases in these patients and inflammatory reaction may not be an important factor of subclinical hypothyroidism complicated with atherosclerosis.
出处
《中国医师进修杂志》
2012年第16期14-17,共4页
Chinese Journal of Postgraduates of Medicine
