老年糖尿病合并亚临床甲减患者颅内动脉粥样硬化发生及影响因素分析  

Occurrence of intracranial atherosclerosis in elderly patients with diabetes and subclinical hypothyroidism and its influencing factors

作　　者：隋淼[1] 于扬[1] 张弢[1] 许静宜[1] 杨晓辉[1] 

机构地区：[1]大连大学附属中山医院内分泌一科,116001

出　　处：《疑难病杂志》2017年第9期877-880,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的分析老年糖尿病合并亚临床甲减患者的颅内动脉粥样硬化发生情况及影响因素。方法选取2015年5月—2016年5大连大学附属中山医院内分泌一科收治的糖尿病患者84例作为研究对象,依据甲状腺功能结果分为糖尿病合并亚临床甲减(DM+SCH)组44例和单纯糖尿病(DM)组40例。比较2组患者的临床基本资料、颅内动脉粥样硬化发生情况、生化指标,并且以颅内动脉粥样硬化作为因变量,将患者基本资料及临床生化指标作为自变量,Logstic回归分析糖尿病合并亚临床甲减患者颅内动脉粥样硬化影响因素。结果 DM+SCH组患者44例中发生颅内动脉粥样硬化34例(77.3%),高于DM组的23例(57.5%),差异有统计学意义(χ~2=8.921,P=0.002)。DM+SCH组收缩压、TPOAb、TSH、HDL-C、SCr、FIB、hs-CRP、Hcy与DM组比较差异有统计学意义(t=3.476、2.467、13.690、1.957、4.103、2.018、5.919、8.394,P<0.05)。多因素Logstic回归分析结果显示,收缩压、SCr、hs-CRP、Hcy、FIB、TSH是颅内动脉粥样硬化的危险因素,HUL-C为保护因子。结论老年糖尿病合并亚临床甲减患者发生颅内动脉粥样硬化的风险增大,其血脂、炎性反应、凝血纤溶系统、同型半胱氨酸、促甲状腺激素是颅内动脉粥样硬化的影响因素。Objective To investigate the occurrence of intracranial atherosclerosis in elderly patients with subclinical hypothyroidism and diabetes and its influencing factors.Methods Eighty-four cases （38 males and 46 females） of patients with diabetes were selected, who were treated in hospital from February 2015 to February 2016, and they were divided into the diabetes＋subclinical hypothyroidism （DM ＋ SCH） group （44 cases） and diabetes（DM） group （40 cases） which based on thyroid function results.The clinic basic data, intracranial atherosclerosis and biochemical markers of the two groups were analyzed, and the intracranial atherosclerosis was used as the dependent variable, the patients＆#39; basic data and clinical biochemical parameters were taken as independent variables, which were added to the logistic regression equation, to analyze the influencing factors of intracranial atherosclerosis in patients with subclinical hypothyroidism and diabetes.Results The systolic blood pressure, TPOAb,TSH,HDL-C, SCr,FIB,hs-CRP, Hcy, intracranial atherosclerosis of the DM＋SCH group were significantly higher than those of the DM group （ t =3.476, t =2.467, t =13.690, t =1.957, t =4.103, t =2.018, t =5.919, t =8.394, P =0.000, P =0.008, P =0.027, P =0.000, P =0.000, P =0.023, P =0.000, P =0.000）;Multivariate logistic regression analysis showed that systolic blood pressure,SCr,hs-CRP, Hcy, FIB, TSH were risk factors of intracranial atherosclerosis,HDL-C was protective factor.Conclusion Subclinical hypothyroidism in patients with diabetes increases the risk of intracranial atherosclerosis, and the blood lipid, inflammatory reaction, coagulation and fibrinolysis system, homocysteine and thyroid stimulating hormone are the influencing factors of intracranial atherosclerosis.

关 键 词：亚临床甲减 糖尿病 颅内动脉粥样硬化 影响因素 老年 

分 类 号：R581.2[医药卫生—内分泌] R587.1[医药卫生—内科学] R743.3[医药卫生—临床医学]