左旋甲状腺素替代治疗对亚临床甲减患者血NO、ET、CIMT的影响  

Effects of Levothyroxine Replacement Therapy on NO,ET and CIMT of Subclinical Hypothyroidism Patients

作　　者：郭雅卿[1] 付淑平[1] 金红莲[2] 张海容[1] 尹娟[1] 朱淑芳[1] 

机构地区：[1]河北大学附属医院,河北保定071000 [2]保定市急救中心,河北保定071000

出　　处：《中国药房》2012年第2期140-142,共3页China Pharmacy

摘　　要：目的:观察亚临床甲减患者左旋甲状腺素(LT4)替代治疗后血脂、内皮素(ET)、一氧化氮(NO)及颈动脉内中膜厚度(CIMT)的变化,探讨亚临床甲减替代治疗对动脉粥样硬化的意义。方法:选取亚临床甲减患者45例,随机分为LT4替代组与安慰剂组,各组疗程前后分别检测低密度脂蛋白(LDL)、甘油三酯(TG)、高密度脂蛋白(HDL)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、一氧化氮(NO)、内皮素(ET)及CIMT。另选甲状腺功能正常者作为对照组。结果:亚临床甲减组NO较对照组减低(P<0.05),LDL、CIMT较对照组增高(P均<0.01)。LT4替代治疗后NO较治疗前增高(P<0.05),LDL、CIMT较治疗前减低(P均<0.05),并与同期安慰剂组比较差异均有统计学意义(P<0.01或P<0.05)。TG、HDL、ET各组比较差异均无统计学意义(P>0.05)。TG、LDL、CIMT与TSH呈正相关(r=0.47、r=0.39、r=0.51,P均<0.01);NO与TSH呈负相关(r=-0.23,P<0.05);HDL、ET与TSH不相关(r=0.11、r=0.07,P均>0.05);NO与CIMT呈负相关(r=-0.49,P<0.01);ET与CIMT呈正相关(r=0.62,P<0.01)。结论:LT4替代治疗可减轻亚临床甲减患者脂代谢紊乱及内皮功能失调。OBJECTIVE： To observe the changes of blood lipid, endothelin （ET）, nitric oxide （NO） and carotid intima-media thickness （CIMT） in subclinical hypothyroidism patients after levothyroxine （LT4） replacement therapy, and to discuss the significance of LT4 replacement therapy to atherosclerosis. METHODS： 45 patients with subclinical hypothyroidism were randomized into LT4 replacement group and placebo group. LDL, TG, HDL, FT3, FT4, TSH, NO, ET and CIMT were measured before and after the course of treatment. And there were healthy volunteers as control group. RESULTS： Compared with control group, NO was reduced （P〈0.05） and LDL and CIMT were increased in subclinical hypothyroidism group （P〈0.01）. After LT4 treatment, the level of NO was higher （P〈0.05） and LDL, CIMT was lower than before （P〈0.05）. There were statistical significance in difference between control group and subclinical hypothyroidism group （P〈0.01 or P〈0.05）. There was no statistical significance in the difference of TG, HDL and ET （P〉0.05）. TG, LDL and CIMT were positively correlated with TSH（r=0.47, r=0.39, r=0.51, P〈0.01）. NO was negatively correlated with TSH（r=-0.23,P〈0.05）. There was no correlation between HDL, ET and TSH （r= 0.11, r=0.07, P〉0.05）. NO was negatively correlated with CIMT （r= - 0.49, P〈0.01）, and ET was positively correlated with CIMT （r= 0.62, P〈 0.01）. CONCLUSION： Levothyroxine replacement could lessen functional disorder of blood vessel endothelium and blood fat derangement in the subclinical hypothyroidism patients.

关 键 词：左旋甲状腺素 亚临床甲减 替代治疗 内皮素 一氧化氮 颈动脉内中膜厚度 

分 类 号：R96[医药卫生—药理学] R977.14[医药卫生—药学]