原发性甲状腺功能减退症患者左旋甲状腺素治疗后血脂的变化  

Changes in Blood Lipids after Levothyroxine Treatment in the Patients with Primary Hypothyroidism

作　　者：刘泽林[1] 陈燕[2] 

机构地区：[1]南昌大学第四附属医院内分泌科,南昌330003 [2]武警江西总队医院内科,南昌330001

出　　处：《实用临床医学（江西）》2008年第11期14-15,18,共3页Practical Clinical Medicine

摘　　要：目的观察原发性甲状腺机能减退症(原发性甲减)患者在左旋甲状腺素治疗后血脂的改变,进一步探讨原发性甲减与血脂的相关性。方法未经治疗的原发性甲减患者42例,在治疗前和经左旋甲状腺素治疗2个月后分别测定空腹血清甲状腺功能指标(包括FT3、FT4、sTSH)和血脂指标(包括TC、TG)。结果治疗后患者甲状腺功能指标均恢复至正常范围,与治疗前相比,均有极显著性差异(P<0.01)。血清TC水平平均下降24.8%,与治疗前相比,有极显著性差异(P<0.01);TG水平平均下降9.2%,与治疗前相比,无显著性差异(P>0.05)。患者治疗前TC水平与FT3呈显著负相关(r=-0.28,P<0.05);与FT4呈显著负相关(r=-0.40,P<0.01);与STSH呈显著正相关(r=0.46,P<0.01)。TG与FT3、FT4及sTSH未表现出相关性。结论原发性甲减患者用左旋甲状腺素治疗后可显著降低胆固醇TC水平,而对甘油三酯(TG)水平则无明显影响;原发性甲减与患者血清TC水平相关。Objective To explore the relationship between primary hypothyroidism and blood lipids by observing the changes in blood lipids after levothyroxine therapy in the patients with primary hypothyroidism. Methods Forty-two patients with primary hypothyroidism without treatment were recruited. Fasting serum thyroid function indexes （ FT3, FT4, and sTSH） and blood lipids indexes （including TC and TG） were examined in those patients before treatment and after levothyroxine treatment For 2 months. Results After treatment for 2 months,reduced FT3 and FT4 levels and elevated sTSH levels were restored to the normal ranges,there were statisticallly significant differences （P〈0.01）of FT3, FT4, and sTSH between after therapy and before therapy with levothyroxine. TC level was decreased by 24. 8 %, there was statistically significant difference（P〈0.01） of that compared with the same thing before therapy. TG level was dropped by 9.2%,there was not statistically significant difference（P〈0.05）of that compared with the same thing before therapy. Before treatment, TC level showed significant negative correlations with FT3（r= -0.28,P〈0.05 ） ,FT4（r =-0.40,P〈0.01）and a significant positive correlation with sTSH （r=0.46,P〈0.01）. TG level change was not associated with FT3, FT4, and sTSH. Conclusion The administration of levothyroxine to primary hypothyroidism patients decrease the elevated TC level, whereas TG level is not correlated with thyroid function.

关 键 词：甲状腺功能减退症 原发性 血脂 甲状腺功能 左旋甲状腺素 

分 类 号：R581.2[医药卫生—内分泌]