亚临床甲减与冠心病患者C反应蛋白、脉搏波传导速度及血小板活化的关系  

Influence of subclinical hypothyroidism on the C-reactive protein, pulse wave velocity and platelet activation in patients with coronary heart disease

作　　者：姚晓璐[1] 涂燕平[1] 戴国荣 曾黎峰[1] 雷梦觉[1] 王晓华[1] 龚爱斌[1] 魏伟荣[1] 王凌玲[1] 艾文伟[1] 邬甦[1] 

机构地区：[1] 江西省人民医院干部病房,江西省南昌市330006 [2] 江西婺源县人民医院内科病房

出　　处：《中国心血管病研究》2015年第9期792-795,共4页Chinese Journal of Cardiovascular Research

基　　金：江西省卫生厅科技计划（项目编号：20143022）

摘　　要：目的 研究亚临床甲减与冠心病患者超敏C反应蛋白、臂踝脉搏波传导速度、血小板活化因子（CD41、CD62P）等心血管事件危险预测因素的关系.方法 选择冠心病合并亚临床甲减及冠心病无亚临床甲减患者各50例.所有患者晚间禁食12h后抽取静脉血行血脂、同型半胱氨酸、甲状腺功能、超敏C反应蛋白、血小板活化因子（CD41、CD62P）检测,并行臂踝脉搏波传导速度检查.比较两组各指标的差异.结果 与甲状腺功能正常冠心病组相比,冠心病合并亚临床甲减组甘油三酯[（1.75±0.63）mmol/L比（1.49±0.48）mmol/L]、总胆固醇[（5.60±0.72） mmol/L比（4.35±0.47）mmol/L]、同型半胱氨酸[（15.63 ±0.96） μmol/L比（13.62±1.41）μmol/L]、超敏C反应蛋白[（4.9±1.4）mg/L比（3.5±1.2）mg/L]、臂踝脉搏波传导速度[（1678.3±211.2）cm/s比（1556.8±206.3）cm/s]和血小板活化因子CD41[（24.3±3.2）％比（18.4±4.1）％]、CD62P[（56.8±3.6）％比（44.9土3.8）％]均升高,差异有统计学意义（P＜0.05或P＜0.01）.结论 亚临床甲减不但影响冠心病患者血脂、同型半胱氨酸代谢,而且与冠心病患者超敏C反应蛋白、臂踝脉搏波传导速度、血小板活化因子（CD41、CD62P）等心血管事件危险预测因素有关.亚临床甲减会增加冠心病患者心血管事件的危险性.Objective To observe the influence of subclinical hypothyroidism on serum high sensitive c-re- active protein （hs-CRP）, braehial-ankle pulse wave velocity （baPWV） and platelet activator （CD62P, CD41 ） in patients with coronary heart disease （CHD）. Methods 100 consecutive coronary heart disease patients were en- rolled in our hospital, and divided into two groups （of them 50 complicated with subclinical hypothyroidism, 50 with euthyroidism）. The level of fast serum total cholesterol （TC）, triglyceride（TG）, homocystine, T3, T4, FT3, FT4, TSH, hs-CRP, CD62P and CD41 were measured in all patients, and the baPWV was detected. All value between the two groups was compared. Results The levels of TC[ （1.75±0.63）mmol/L vs. （1.49±0.48）mmol/L], TG [ （ 5.60 ±0.72 ）mmol/L vs. （ 4.35 ±0.47 ）mmol/L ], homocystine [ （ 15.63 ±0.96 ） μ mol/L vs. （ 13.62 ± 1.41 ） μmol/L], hs-CRPE（4.9±1.4）mg/L vs. （3.5±1.2）mg/L], baPWV[（1678.3±211.2）em/s vs. （1556.8±206.3）em/s], CD41[（24.3±3.2）% vs. （18.4±4.1）%] and CD62P[（56.8±3.6）% vs. （44.9±3.8）%] inereased significantly in the CHD patients complicated with subelinieal hypothyroidism as compared with those with euthyroidism（P〈0.05 or P〈 0.01 ）. Conclusion Subclinical hypothyroidism can not only affect lipid and homoeystine metabolism, but also is associated with some cardiovascular risk faetors such as hs-CRP, baPWV and platelet activator （CD62P, CD41 ）. Subclinical hypothyroidism may contribute a raised cardiovascular risk to patients with coronary heart disease.

关 键 词：亚临床甲状腺功能减退 冠状动脉疾病 超敏C反应蛋白 臂踝脉搏波传导速度 血小板活化因子(CD62P、CD41) 

分 类 号：R541.4[医药卫生—心血管疾病]