甲状腺功能亢进患者甲状腺功能与肺动脉收缩压相关性研究  

Correlation Research between Thyroid Function and Pulmonary Artery Systolic Pressure in Patients with Hyperthyroidism

作　　者：刘丹[1] 王瑞英[2] 郝凤杰[1] 王立东[1] 汪冬梅[1] 刘海英[1] 

机构地区：[1]承德市中心医院内分泌科,河北承德067000 [2]河北医科大学第二医院内分泌科,石家庄050000

出　　处：《解放军医药杂志》2016年第10期69-72,80,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅科研基金(20160301)

摘　　要：目的探讨甲状腺功能亢进(甲亢)患者的肺动脉收缩压(pulmonary artery systolic pressure,PASP)变化特点,分析PASP与甲状腺抗体水平的相关性。方法选择2013年12月—2014年10月符合研究标准不同时期的甲亢患者,其中临床甲亢组30例,亚临床甲亢组30例,临床缓解组30例,选择同期健康人群30例作为健康对照组。对PASP、脑钠肽(BNP)水平、甲状腺相关抗体水平进行测定,并分析PASP与甲状腺功能、抗体和BNP的相关性。结果临床甲亢组游离三碘甲状腺原氨酸、游离甲状腺素高于其他3组,促甲状腺激素低于健康对照组和临床缓解组(P<0.05)。临床甲亢组、亚临床甲亢组和临床缓解组抗甲状腺过氧化物酶抗体、促甲状腺激素受体抗体、甲状腺球蛋白抗体、PASP水平和肺动脉高压患病率高于健康对照组,且临床甲亢组PASP水平高于亚临床甲亢组和临床缓解组(P<0.05)。PASP水平与TSH呈轻度负相关(r=-0.452,P=0.018),与血浆BNP值呈中度正相关(r=0.557,P<0.05)。结论甲亢患者肺动脉高压患病率高于正常人群,且在亚临床甲亢阶段即可发生,PASP水平随甲亢的严重程度加重而增高,但PASP水平与甲状腺抗体水平无明显相关性,血浆BNP值可用来评估甲亢患者肺动脉高压的发生风险。Objective To investigate characteristics of pulmonary artery systolic pressure（ PASP） in patients with hyperthyroidism and to analyze correlation between PASP and thyroid antibody levels. Methods According to study standards,patients with hyperthyroidism during December 2013 and October 2014 were recruited in this study,who included clinical hyperthyroidism group（ n = 30）,sub-clinical hyperthyroidism group（ n = 30）,clinical remission group（ n = 30） and healthy control group（ n = 30）. Levels of PASP,brain natriuretic peptide（ BNP） and thyroid antibodies were detected,and correlations between PASP with thyroid function,antibodies and BNP were also analyzed. Results In clinical hyperthyroidism group,levels of free triiodothyronine and free thyroxine were higher than other three groups（ P〈0. 05）,while thyroid stimulating hormone（ TSH） level was lower than those in healthy and clinical remission groups（ P〈0. 05）. Values of anti-thyroid peroxidase antibody,thyrotrophin receptor antibody,thyroglobulin antibody,PASP and prevalence rate of pulmonary arterial hypertension（ PAH） in clinical hyperthyroidism,sub-clinical hyperthyroidism and clinical remission groups were higher compared with those in healthy control group,and PASP level in clinical hyperthyroidism group was higher than those in sub-clinical hyperthyroidism and clinical remission groups（ P 〈0. 005）. PASP was negative correlation with TSH（ r =- 0. 452,P = 0. 018）,but it was positive correlation with BNP（ r = 0. 557,P〈0. 05）. Conclusion PAH prevalence rate in patients with hyperthyroidism is higher than that in healthy people,and PAH may occur in sub-clinical stage of hyperthyroidism,and PASP level is increasing with enhancing severity of the disease. PASP level showed no obvious correlation with thyroid antibody,but BNP value can be used to evaluate risk of PAH pathogenesy in patients with hyperthyroidism.

关 键 词：甲状腺功能亢进症 高血压 肺性 利钠肽 脑 甲状腺激素类 

分 类 号：R581.1[医药卫生—内分泌]