女性甲减患者甲状腺素治疗改善内皮细胞依赖性血管舒张功能  

Amelioration of endothelium-dependent arterial dilation in female hypothyroidism patients with thyroxine therapy

作　　者：向光大[1] 赵林双[1] 何玉生[1] 王运林[1] 

机构地区：[1]广州军区武汉总医院内分泌科,武汉430070

出　　处：《中华内分泌代谢杂志》2005年第2期118-120,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　观察甲状腺功能减退症(甲减)患者甲状腺激素补充治疗后内皮依赖性血管舒张功能的变化。方法　选择初诊的女性临床甲减患者33例、亚临床甲减患者25例及正常健康女性25名。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油(GNT)介导的非内皮依赖性血管舒张功能。结果　(1)与对照组比较,临床甲减组和亚临床甲减组治疗前TSH、脂蛋白(a)〔L(a)〕、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL C)水平明显升高,血流介导的血管舒张功能降低(均<0. 05)。(2)与治疗前比较,临床甲减组和亚临床甲减组TSH、Lp(a)、LDL C、载脂蛋白B水平明显降低;血流介导的血管舒张功能明显升高(均P<0. 05)。(3)临床甲减组和亚临床甲减组治疗前后TSH、Lp(a)LDL C的变化与血流介导的血管舒张功能呈负相关(均P<0. 05)。结论　甲减患者内皮依赖性血管舒张功能降低,甲状腺激素补充治疗可改善内皮功能。Objective To study the changes of endothelium-dependent arterial dilation in female patients with hypothyroidism after thyroxine therapy. Methods Thirty-three female patients with overt hypothyroidism and 25 patients with subclinical hypothyroidism as well as 25 healthy female individuals were selected, and high resolution echography was performed to measure changes of blood flow-mediated endothelium-dependent arterial dilation and glyceryltrinitrate (GNT)-mediated endothelium-independent arterial dilation of brachial artery. Results (1) Before treatment, TSH、lipoprotein (a) \、total cholesterol (TC)、low density lipoprotein cholesterol (LDL-C) concentrations were higher in both groups with overt hypothyroidism and subclinical hypothyroidism than those in controls, and the flow-mediated arterial dilation was lower than that in controls (all P<0.05). (2) After treatment, the TSH、Lp(a)、LDL-C、ApoB concentrations decreased in both groups of overt hypothyroidism and subclinical hypothyroidism and the flow-mediated arterial dilation increased (all P<0.05). (3) During the treatment, the absolute changes of the flow-mediated arterial dilation showed negative correlation with the changes of TSH、Lp(a)、LDL-C (all P<0.05). Conclusion The endothelium-dependent arterial dilation in hypothyroidism decreases significantly, which improves after thyroxine treatment.

关 键 词：女性 甲状腺素 药物治疗 内皮细胞 依赖性血管舒张功能 甲状腺功能减退症 

分 类 号：R581.2[医药卫生—内分泌] R977[医药卫生—内科学]