老年2型糖尿病合并亚临床甲状腺功能减退症患者血管舒张功能的影响因素研究  

Influencing Factors of Vasodilation in Elderly Type 2 Diabetic Patients with Subclinical Hypothyroidism

作　　者：付秀立[1] 赵湜[1] 毛红[1] 王中京[1] 

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院内分泌科,湖北省武汉市430014

出　　处：《中国全科医学》2013年第23期2674-2676,共3页Chinese General Practice

摘　　要：目的探讨老年2型糖尿病合并亚临床甲状腺功能减退症(甲减)患者血管舒张功能的影响因素。方法选择武汉市中心医院内分泌科2009年4月—2011年10月住院的老年2型糖尿病患者241例,将其中未合并亚临床甲减者144例纳入对照组,合并亚临床甲减者97例纳入观察组。采用彩色多普勒超声仪检测肱动脉血流介导的血管舒张功能(FMD)。结果观察组患者的促甲状腺素(TSH)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、白介素6(IL-6)高于对照组,FMD低于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,观察组患者的TSH、hs-CRP、IL-6、TG、TC与FMD呈负相关(P<0.01)。多因素Logistic回归分析结果显示,TSH、hs-CRP、IL-6对回归方程的影响均有统计学意义(P<0.01)。结论亚临床甲减加重了老年2型糖尿病患者的血管内皮功能损伤,TSH、hs-CRP、IL-6水平升高是其危险因素。Objective To explore the influencing factors of vasodilation in elderly type 2 diabetic patients with subclin- ical hypothyroidism. Methods A total of 241 elderly type 2 diabetic patients admitted to our department between April 2009 and October 2011 were selected and divided into an observation group （with subclinical hypothyroidism, n = 97 ） and a control group （without subclinical hypothyroidism, n = 144）. The color Doppler was used to detect the brachial artery flow - mediated dilation （FMD）. Results The patients in the observation group had higher levels of thyroid stimulating hormone （TSH）, triglyceride （TG）, total cholesterol （TC）, low density lipoprotein- cholesterol （LDL- C）, high sensitivity- C reactive protein （hs- CRP）, interleukin -6 （IL- 6）, but lower FMD than those in the control group （P 〈 0.05 ）. Pearson correlation analysis re- suits showed that FMD was negatively correlated with TSH, hs - CRP, IL - 6, TG, and TC in the observation group （ P 〈 0. 01 ）. Multiple Logistic regression analysis results showed that TSH, hs - CRP, and IL -6 had significant impact on the re- gression equation （P 〈 0. 01 ）. Conclusion Subclinical hypothyroidism aggravates endothelial damage in elderly type 2 diabetic patients. Increases of TSH, hs -CRP, and IL-6 are the risk factors for the damage.

关 键 词：糖尿病 2型 亚临床甲状腺功能减退症 血管舒张功能 

分 类 号：R581.2[医药卫生—内分泌] R587.1[医药卫生—内科学]