亚临床甲状腺功能减退症患者促甲状腺素与脑血管病危险因素关系的研究  

Relationship between TSH level and risk factors for cerebrovascular disease in subclinical hypothyroidism patients

作　　者：宣丽萍[1] 杨振兴 于媚[1] 黄勇敏[1] 董素琴[1] 陈彬 XUAN Li-ping;YANG Zhen-xing;YU Mei(Department of Endocrinology,Yuyao People's Hospital,Yuyao,Zhejiang 315400,China)

机构地区：[1]余姚市人民医院内分泌科,浙江余姚315400 [2]宁波市第七医院内三科,浙江宁波315200

出　　处：《中华全科医学》2018年第12期2006-2009,共4页Chinese Journal of General Practice

基　　金：浙江省医药科技卫生项目(2018KY723);余姚市人民医院院级课题(2016YA03)

摘　　要：目的探讨亚临床甲状腺功能减退症(SCH)患者促甲状腺素(TSH)与脑血管病危险因素的关系及意义。方法选择2016年6月—2017年7月160例在余姚市人民医院初次诊断的SCH患者,根据TSH水平将SCH患者分为A组(90例,4.95mIU/L<TSH≤10.00mIU/L),B组(70例,TSH>10.00mIU/L),并选取50名甲状腺功能正常健康人群作为对照组。检测各组的TSH、血压、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、颈动脉内膜中层厚度(CIMT)、腰围、体重指数(BMI)、同型半胱氨酸(Hcy)等脑血管病危险因素,分析TSH与上述脑血管病危险因素的关系。结果A、B组BMI、TC、TG、LDL-C、Hcy、TSH、CIMT均明显高于对照组,B组TC、TG、LDL-C、Hcy、TSH、CIMT均明显高于A组、对照组(均P<0.05)。SCH患者中,TSH与BMI、TC、TG、LDL-C、Hcy、CIMT呈正相关,与HDL-C呈负相关(均P<0.05),多重线性回归分析显示,TSH为LDL-C、Hcy、CIMT升高的独立危险因素(均P<0.05)。结论TSH与脑血管病危险因素密切相关,是影响脑血管病发生发展的因素之一。Objective To explore the relationship between thyroid stimulating hormone ( TSH) level and risk factors for cerebrovascular disease in subclinical hypothyroidism ( SCH) patients and its significance. Methods According to the TSH level,the 160 cases of newly diagnosed SCH in our hospital between June,2016 and July,2017 were divided into group A ( 90 cases,4. 95 mIU/L < TSH < 10. 00 mIU/L) and group B ( 70 cases,TSH > 10. 00 mIU/L) . And 50 healthy people with normal thyroid function were assigned into the control group. The levels of the serum TSH,blood pressure,fasting plasma glucose ( FPG) ,glycosylated hemoglobin ( HbA1c) ,total cholesterol ( TC) ,triglyceride ( TG) ,high-density lipoprotein cholesterol ( HDL-C) ,low density lipoprotein cholesterol ( LDL-C) ,carotid intimamedia thickness ( CIMT) ,waist circumference ( WC) ,body mass index ( BMI) ,homocysteine ( Hcy) ,and other risk factors for cerebrovascular disease were measured. The relationship between thyroid stimulating hormone ( TSH) level and risk factors for cerebrovascular disease was analyzed. Results The levels of BMI,TC,TG,LDL-C,Hcy,TSH and CIMT in group A and B was significantly higher than those in the control group ( P < 0. 05) . Meanwhile,the levels of TC, TG,LDL-C,Hcy,TSH and CIMT in group B was higher as compared with those in group A and control group ( P < 0. 05) . In SCH patients,TSH was positively correlated with the levels of BMI,TC,TG,LDL-C,Hcy and CIMT,and negatively correlated with HDL-C ( all P < 0. 05) . Multiple linear regression analysis showed that TSH was an independent risk factor for the elevated LDL-C,Hcy,and CIMT ( all P < 0. 05) . Conclusion TSH is closely related to the risk factors for cerebrovascular disease,and is one of the factors that affect the occurrence and development of cerebrovascular disease.

关 键 词：亚临床甲状腺功能减退 促甲状腺素 脑血管病危险因素 

分 类 号：R581.2[医药卫生—内分泌] R743[医药卫生—内科学]