亚临床甲状腺功能减退症合并心血管疾病患者的临床特征分析  

Clinical features of cardiovascular disease patients with complicated subclinical hypothyroidism

作　　者：苗莉[1] 丁瑾[2] 严庭智 刘迎午[1] 姚小梅[2] 

机构地区：[1]天津市第三中心医院心脏科,300170 [2]天津医科大学基础医学院

出　　处：《天津医药》2016年第11期1308-1310,共3页Tianjin Medical Journal

基　　金：国家自然科学基金项目资助(81273009);天津市科委课题(16JCYBJC26100);天津医科大学基础医学院大学生科研基金

摘　　要：目的观察亚临床甲状腺功能减退症(亚甲减)合并心血管疾病患者的临床特征。方法选取我院2013年1月—2015年6月收治的132例心血管疾病患者,根据促甲状腺激素(TSH)水平,分为甲状腺功能正常组(正常组,0.27 m IU/L<TSH≤4.50 m IU/L,43例)、轻度亚甲减组(轻度组,4.50 m IU/L<TSH<10.00 m IU/L,62例)、重度亚甲减组(重度组,TSH≥10.00 m IU/L,27例)。比较3组性别、年龄等一般资料;检测患者空腹血糖(FPG)、血脂、甲状腺过氧化物酶抗体(anti-TPO)、B型尿钠肽(BNP)等生化指标;并行超声心动图检查,计算左室射血分数(LVEF)及心动周期中舒张早期心室充盈的最大值(E峰)与舒张晚期心房充盈最大值(A峰)的比值(E/A)。结果轻度组女性患者所占比例高于其余2组(P<0.05),重度组的anti-TPO阳性率高于其他2组(P<0.05),3组间FPG、血脂、BNP异常比例和E/A异常比例差异无统计学意义(P>0.05)。结论 anti-TPO阳性的女性心血管疾病患者在临床治疗中应予以重视。Objective To observe the clinical features in cardiovascular disease(CVD) patients with complicatedsubclinical hypothyroidism. Methods A total of 132 CVD patients hospitalized in Tianjin Third Central Hospital fromJanuary 2013 to June 2015 were included in this study. According to the thyrotropin(TSH) level, patients were divided intothree groups: normal thyroid function group(0.27 m IU/L<TSH≤4.50 m IU/L, n=43), mild subclinical hypothyroidism group(4.50 m IU/L < TSH < 10.00 m IU/L, n=62) and severe subclinical hypothyroidism group(TSH≥10.0 m IU/L, n=27). Data ofgender, age and other general information were recorded. The biochemical indicators were measured including fastingplasma glucose(FPG), lipid, anti- TPO and B- type natriuretic peptide(BNP). The echocardiographic examination wasperformed, and left ventricular ejection fraction(LVEF) and the ratio of the maximal value of early diastolic ventricularfilling wave(E wave) to the maximal value of late diastolic atrial filling wave(A wave) in the cardiac cycle(E/A) were alsocalculated. Results The proportion of females was significantly higher in CVD patients with mild subclinicalhypothyroidism than that of other two groups(P < 0.05). The positive rate of anti-TPO was significantly higher in CVDpatients with complicated severe subclinical hypothyroidism compared to that of other two groups(P < 0.05). There were nosignificant differences in FPG, lipid, the proportion of abnormal BNP, and the proportion of abnormal E/A ratio between thethree groups(P > 0.05). Conclusion The female CVD patients with accompanied positive anti- TPO should be paidattention in clinical treatment.

关 键 词：甲状腺功能减退症 亚临床甲状腺功能减退症 心血管疾病 危险因素 血糖 血脂 甲状腺过氧化物酶抗体 

分 类 号：R581.2[医药卫生—内分泌] R54[医药卫生—内科学]