亚临床甲功异常患者血脂、HCY、血常规与甲功指标的相关分析  

Correlation analysis of blood lipid,homocysteine,blood routine test and thyroid function parameters in patients with subclinical thyroid dysfunction

作　　者：段文冰[1] 刘芸[1] 张璐璐[1] 刘义刚[1] 王子娥[1] 唐闻[1] 赵万辉[1] 张炳昌[1] 

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《新医学》2018年第1期42-46,共5页Journal of New Medicine

基　　金：山东省自然科学基金(ZR2016HM52);山东省科学技术发展计划(2014GGH218041);山东省临床重点专科建设项目(鲁卫医字2013-26)

摘　　要：目的分析亚临床甲状腺功能异常患者血脂、同型半胱氨酸(HCY)及血常规水平的变化情况,探讨其与甲状腺功能指标的相关性。方法选取69例亚临床甲状腺功能亢进(甲亢)患者、95例亚临床甲状腺功能减退(甲减)患者及健康的200名正常对照者为研究对象,比较3者血清TSH、FT_3、FT_4、血脂、同型半胱氨酸、血常规等项目;采用Pearson法分析亚甲状腺功能异常患者的甲状腺功能指标与上述指标的相关性。结果 (1)亚临床甲亢组和亚临床甲减组55岁以上患者的发病率高于55以下人群,且女性发病率高于男性。(2)亚临床甲亢组总胆固醇、甘油三酯、LDL-C、小而密低密度脂蛋白胆固醇(sdLDL-C)、游离脂肪酸(NEFA)、TSH均低于正常对照组,HDL-C、FT_4均高于正常对照组(P均<0.05);亚临床甲减组总胆固醇、甘油三酯、LDL-C、sdLDL-C、NEFA、HCY、白细胞、TSH均高于正常对照组,HDL-C、FT_4、红细胞、血红蛋白均低于对照组(P均<0.05)。(3)亚临床甲亢组FT_3与甘油三酯、sdLDL-C呈负相关,FT_4与甘油三酯、HCY、sdLDL-C呈负相关,Ln TSH与甘油三酯、sdLDL-C呈正相关;亚临床甲减组FT_3水平与甘油三酯、sdLDL-C、HDL-C呈负相关,与红细胞、血红蛋白呈正相关;FT_4与总胆固醇、LDL-C、sdLDL-C、NEFA、HCY呈负相关,与红细胞、血红蛋白呈正相关,LnTSH与总胆固醇、甘油三酯、sdLDL-C呈正相关,与HDL-C呈负相关。结论老年女性是亚临床甲状腺功能异常的高发人群,亚临床甲亢和亚临床甲减患者均存在血脂代谢紊乱,并且可引起外周血细胞不同程度的改变,且与部分甲状腺功能指标相关。Objective To analyze the changes of blood lipid,homocysteine( HCY) and blood routine levels in patients with subclinical thyroid dysfunction,aiming to explore the correlation between these parameters and thyroid function parameters. Methods Sixty-nine patients with subclinical hyperthyroidism( hyperthyroidism),95 with subclinical hypothyroidism( hypothyroidism) and 200 healthy controls were recruited in this study. The serum levels of thyroid stimulating hormone( TSH),free thyroxine 3( FT_3),FT_4,blood lipid,HCY and blood routine levels were statistically compared among three groups. Pearson correlation analysis was adopted to investigate the correlation between these indexes and thyroid function parameters. Results(1)In the subclinical hyperthyroidism and subclinical hypothyroidism groups,the prevalence rate in patients aged > 55 years was significantly higher than that in their counterparts aged < 55 years,and the prevalence rate in the female was higher compared with that in the male.(2)In the subclinical hyperthyroidism group,the serum levels of total cholesterol( TC),triglyceride( TG),low-density lipoprotein cholesterol( LDL-C),small-and low-density lipoprotein cholesterol( sdLDL-C),free fatty acid( NEFA) and TSH were significantly lower,whereas the serum levels of HDL-C and FT_4 were considerably higher than those in the control group( all P < 0. 05). In the subclinical hypothyroidism group,the serum levels of TC,TG,LDL-C,sdLDL-C,NEFA,HCY,white blood cells and TSH were significantly higher,whereas the levels of HDL-C,FT_4,red blood cells and hemoglobin were dramatically lower than those in the control group( all P < 0. 05).(3)In the subclinical hyperthyroidism group,the serum levels of FT_3 level was negatively correlated with TG and sdLDL-C,FT_4 level was negatively correlated with TG,HCY and sdLDL-C,and Ln TSH was positively correlated with TG and sdLDL-C. In the subclinical hypothyroidism group,FT_3 level was negatively correlated with TG,sdLDL-C and HDL-C,whereas positively correlated with red blood cel

关 键 词：亚临床 甲状腺功能异常 血脂 同型半胱氨酸 血常规 

分 类 号：R581[医药卫生—内分泌]