儿童及青少年血清促甲状腺激素和血压关系的研究  

The association between serum thyroid stimulating hormone concentration and blood pressure in children and adolescents

作　　者：陈欢欢[1] 席倩[2] 宋斌[1] 李杰[1] 申红梅[1] 茅晓东[2] 张家明[3] 王志国[3] 刘超[1] 

机构地区：[1]南京医科大学第一附属医院内分泌科,江苏南京210029 [2]蚌埠市第三人民医院内分泌科,安徽蚌埠233000 [3]江苏省中医药研究院临床检验中心,江苏南京210028

出　　处：《南京医科大学学报（自然科学版）》2010年第6期822-826,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省医学领军人才项目

摘　　要：目的:研究学龄儿童及青少年血清促甲状腺激素(TSH)水平和血压的关系。方法:采用随机整群抽样的方法对安徽蚌埠地区880名7～18岁学龄儿童及青少年进行横断面调查,填写问卷,测量血压、身高、体重,空腹抽血测血清TSH,TSH异常者进一步测血清游离三碘甲状腺游氨酸(FT3)、游离甲状腺素(FT4)。分析不同甲状腺功能状态组的收缩压(SBP)和舒张压(DBP)的特征,了解这一人群TSH与血压的关联。结果:①血清TSH与SBP和DBP均存在正相关关系,在校正了年龄、性别、体质指数(BMI)的影响后,血清TSH与SBP和DBP的正向相关性依然存在;按性别分层发现,这种正相关关系在男性中尤其明显(相关系数r分别为0.1155、0.1302,P分别为0.007、0.002);②亚临床甲状腺功能减退(亚甲减)组的SBP和DBP水平高于甲状腺功能正常组,分别增加2.6mmHg和2.2mmHg。结论:随着血清TSH的增加,SBP和DBP有所升高,学龄儿童及青少年亚甲减组血压高于甲功正常组,此研究为儿童及青少年高血压人群中的重点筛查和亚临床甲减早期干预治疗提供了临床依据。Objective：To investigate the relationship between levels of serum thyroid stimulating hormone（TSH）and blood pressure in the school-age children and adolescents. Methods：A cross-sectional survey on 880 subjects aged 7-18 in Bengbu,Anhui province was carried out with a questionnaire,blood pressure,height,and body weight measurement on the basis of random cluster sampling method. Blood samples were taken in fasting state to test TSH. FT3 and FT4 were further examined if TSH was abnormal. The relationship between different levels of serum TSH and systolic and diastolic blood pressure（SBP and DBP）was analyzed. Results：（1）Serum TSH and SBP, DBP were positively correlated. After adjusting for age,sex,and body mass index （BMI）,the positive correlation between TSH and blood pressure was still remained and was more significant in male （correlation coefficient r=0.115 5,0.130 2,P=0.007,0.002）. （2）SBP and DBP in subclinical hypothyroidism group were higher than those in normal subjects,increased by 2.6 mmHg,2.2 mmHg,respectively. Conclusion：SBP and DBP were increased with the increment of TSH in normal subjects and the participants with subclinical thyroid disease. Among the school-age children and adolescents, blood pressure was higher in subclinical hypothyroidism subjects than that in normal. This study provides evidence for screening thyroid function in hypertensive children and adolescents and treatment for subclinical hypothyroidism.

关 键 词：儿童及青少年 促甲状腺激素 亚临床甲状腺功能减退 血压 

分 类 号：R581.2[医药卫生—内分泌]