左甲状腺素对甲状腺功能减退症及亚临床甲状腺功能减退症患者血脂的影响  

Effect of Levothyroxine on Blood Lipid in Patients with Clinical or Subclinical Hypothyroidism

作　　者：张国峰[1] 

机构地区：[1]中国医科大学附属第一医院内分泌实验室,辽宁省沈阳市110001

出　　处：《中国全科医学》2010年第20期2213-2215,共3页Chinese General Practice

摘　　要：目的观察亚临床甲状腺功能减退症(亚临床甲减)及临床甲状腺功能减退症(临床甲减)患者左甲状腺素替代治疗前后的血脂水平。方法选择67例亚临床甲减患者和63例临床甲减患者,均给予左甲状腺素替代治疗。治疗前后用电化学发光法测定促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,用酶法测定血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平。结果校正年龄、性别等因素后,亚临床甲减组患者的HDL水平与临床甲减组比较,差异无统计学意义(P>0.05);而血清TC、TG、LDL水平均显著低于临床甲减组,差异均有统计学意义(P<0.01),但已经明显超过血脂正常值。治疗后亚临床甲减组和临床甲减组患者的甲状腺功能(FT3、FT4、TSH)恢复或基本恢复正常,血清TC、TG、LDL水平较治疗前均显著降低,差异有统计学意义(P<0.01)。临床甲减组患者的TC、TG下降幅度显著大于亚临床甲减组,LDL下降幅度显著小于亚临床甲减组,差异有统计学意义(P<0.01);两组HDL-C水平间差异无统计学意义(P>0.05)。结论亚临床甲减及临床甲减均出现血脂代谢异常;应用左甲状腺素替代治疗后,患者的甲状腺功能逐渐恢复,血脂异常状况亦得到不同程度的改善。Objective To observe the changes in blood lipids after levothyroxine replacement therapy in patients with clinical or subclinical hypothyroidism. Methods Sixty - three clinical hypothyroidism （ CH ） patients and 67 subclinical hypothyroidism （SCH） were both given levothyroxine （L - T4 ） replacement therapy. The levels of thyroid stimulating hormone （TSH）, free triiodothyronine 3 （ FT3 ）, free thyroxine （ FT4 ） were detected by electrochemicuminescence, and the levels of ser- um total cholesterol （TC）, triglyceride （TG）, low density lipoprotein （ LDL）, high density lipoprotein （HLD） by enzymic method before and after treatment. Results After correction of age, gender and other factors, there was not significant difference in HDL level between 2 groups （P 〉 0. 05） , while levels of TC, TG, LDL were significantly lower in SCH group than in CH group （P 〈 0. 01 ） , obviously exceeding the normal blood lipid. After treatment, the thyroid function （FT3, FT4, TSH） returned completely or basically to normal, levels of TC, TG, LDL decreased significantly in 2 groups as compared with pre - treatment （P 〈 0. 01 ）. TC, TG decreased more, LDL less in CH group than in SCH group （P 〈0. 01 ）. No significant difference was noted in HDL - C level changes between 2 groups （P 〉0.05）. Conclusion Abnormal lipid metabolism appears in both clinical and subclinical hypothyroidism patients. After levothyroxine replacement therapy, the thyroid function recovers gradually, and lipid abnormality is improved to varying degrees.

关 键 词：甲状腺素 甲状腺功能减退症 血脂 

分 类 号：R581.2[医药卫生—内分泌]