摘要
目的探讨甲状腺功能减退症(hypothyroidism,PWH)患者经左甲状腺素治疗后对血管内皮功能的影响。方法选取我院2014年1月—2015年8月初治PWH患者80例,均给予左甲状腺素口服治疗。比较治疗前、治疗后6个月血总三碘甲状腺原氨酸(TT_3)、游离三碘甲状腺原氨酸(FT_3)、总甲状腺素(TT_4)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)、抗凝血酶Ⅲ(AT-Ⅲ)活性、C-反应蛋白(CRP)、纤维蛋白原(FIB)、同型半胱氨酸(HCY)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)及肱动脉血流介导的血管舒张(flow-mediated dilatation,FMD)指数,并进一步行多元线性回归分析各实验室指标对血管内皮功能的影响。结果治疗后6个月血TT_3、FT_3、TT_4、FT_4、AT-Ⅲ活性、HDL-C、FMD指数明显高于治疗前,TSH、CRP、FIB、HCY、TC、LDL-C、TG明显低于治疗前,差异均有统计学意义(P<0.05或P<0.01)。多元线性回归分析结果显示:TT_3、TT_4、FT_4、TSH、CRP、HCY、TC、LDL-C是血管内皮舒张功能的危险影响因子,HDL-C、AT-Ⅲ活性为血管内皮舒张功能的保护因子。结论通过左甲状腺素治疗能改善PWH患者血管内皮舒张功能。
Objective To investigate the effect of Levothyroxine on vascular endothelial function of patients with hy-pothyroidism （DWH）. Methods A total of 80 patients with hypothyroidism during January 2014 and Augest 2015 all received Levothyroxine orally. Levels of blood total triiodothyronine （ TT3 ）, free triiodothyronine （ FT3 ）, total thyroxine （TT4）,free thyroxine （ FT4 ）, thyroid stimulating hormone （ TSH）, plasma antithrombin Ⅲ（ AT-Ⅲ） activity and C-reactive protein （CRP）, fibrinogen （FIB） and homocysteic acid （HCY）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C） , low density lipoprotein cholesterol （LDL-C）, triglyceride （TG） and brachial artery flow-mediated dilatation （FMD） indexes before and after 6 months of treatment were compared. Multiple linear regression analysis was performed to analyze effects of each index on FMD function. Results After 6 months of treatment, TT3 , FT3 , TT4 , FT4 , AT-Ill activity, HDL-C and FMD index levels were significantly higher, while TSH, CRP, FIB, HCY, TC, LDL-C and TG levels were signif- icantly lower than those before treatment （P 〈 0.05 or P 〈 0. 01 ）. Multiple linear regression analysis showed that TT3 , TT4 , FT4, TSH, CRP, HCY, TC and LDL-C were risk factors of FMD, while HDL-C and AT-Ⅲ activity were protection factor of FMD. Conclusion Levothyroxine treatment can improve FMD of patients with hypothyroidism.
作者
潘伟
刘观鑫
韦彩芬
覃方生
陈聿峰
PAN Wei LIU Guan-xin WEI Cai-fen QIN Fang-sheng CHEN Yu-feng(Department of Nuclear Medicine and Endocrinology, 2. Department of Ultrasonography, 3. Department of Clinical Laboratory 4. Department of Cardiology, the Second Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi Zhuang Nationality Autonomous Region 545006, Chin)
出处
《临床误诊误治》
2017年第1期91-94,共4页
Clinical Misdiagnosis & Mistherapy
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(z2014019)
