老老年原发性高血压病人甲状腺功能特点及影响因素分析  

Analysis of Thyroid Function and Its Risk Factors in Very Elderly Patients with Essential Hypertension

作　　者：魏艺[1] 胡元会[1] 杨传华 宋庆桥[1] 耿彦婷[1] 郑昭瀛[1] WEI Yi;HU Yuanhui;YANG Chuanhua;SONG Qingqiao;GENG Yanting;ZHENG Zhaoying(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]山东中医药大学第一附属医院

出　　处：《中西医结合心脑血管病杂志》2019年第1期21-25,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金(No.81673971)

摘　　要：目的探讨老老年原发性高血压病人甲状腺功能的特点及相关影响因素。方法选取2011年4月—2013年4月心内科住院及2012年—2013年体检科查体的高血压病人187例,根据年龄分为4组:年龄≥80岁为1组,60～79岁为2组,40～59岁为3组,<40岁为4组;比较各组间甲状腺功能指标。结果各组三碘甲状腺原氨酸(T3)比较:4组(1.23±0.14 ng/mL)>3组(1.19±0.15ng/mL)>2组(1.12±0.24 ng/mL)>1组(0.85±0.19 ng/mL),4组间比较差异有统计学意义(P <0.01)。游离三碘甲状腺原氨酸(FT3)水平比较:4组(3.74±0.35 pg/mL)>3组(3.60±0.31 pg/mL)>2组(3.22±0.50 pg/mL)>1组(2.44±0.48 pg/mL),4组间比较差异有统计学意义(P <0.01)。游离甲状腺激素(FT4)各组比较,1组(14.43±3.31 ng/L)>2组(9.53±1.61 ng/L)>4组(9.54±1.26 ng/L)>3组(9.25±1.24 ng/L),4组间比较差异有统计学意义(P <0.01)。1组与3组比较,促甲状腺激素(TSH)差异有统计学意义(P <0.01),其余各组比较差异无统计学意义(P>0.05);各组甲状腺激素(T4)水平比较差异无统计学意义(P>0.05)。多元线性逐步回归分析显示:年龄、舒张压为T3、T4共同影响因素;总胆红素(TBIL)、直接胆红素(DBIL)、肌酐(Cr)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)为FT4的影响因素。结论老老年高血压病人T3、FT3水平最低,FT4水平最高,T3、FT3的影响因素为年龄、舒张压,T4的影响因素为TBIL、DBIL、Cr、HDL-C、LDL-C,在老老年高血压病人的诊疗中,对甲状腺功能的观察有着重要的临床价值。Objective To investigate the characteristics of thyroid function and related influencing factors in very elderly patients with essential hypertension.Methods One hundred and eighty seven patients with essential hypertension admitted to the Department of Cardiology from April 2011 to April 2013 and those who were examined in the Department of Physical Examination from 2012 to 2013 were selected and divided into 4 groups according to age:age≥80 years old for group 1,60 to 79 years old for group 2,40 to 59 years old for group 3,<40 years old for group 4.The thyroid function indicators were compared.Results Triiodothyronine(T3)level was(1.23±0.14)ng/mL,(1.19±0.15)ng/mL,(1.12±0.24)ng/mL,and(0.85±0.19)ng/mL in group 4,group 3,group 2,and group 1,respectively.There was a significant difference among 4 groups(P<0.01).The free triiodothyronine(FT3)level was(3.74±0.35)pg/mL,(3.60±0.31)pg/mL,(3.22±0.50)pg/mL,and(2.44±0.48)pg/mL in group 4,group 3,group 2,and group 1,respectively.There was a significant difference among 4 groups(P<0.01).The free thyroid hormone(FT4)level was(14.43±3.31)ng/L,(9.53±1.61)ng/L,(9.54±1.26)ng/L,and(9.25±1.24)ng/L in group 1,group 2,group 3,and group 4,respectively.There was a significant difference among 4 groups(P<0.01).There was a significant difference in thyroid stimulating hormone(TSH)between group 1 and group 3,and the difference between the other groups was not significant(P >0.05).There was no significant difference in T4 level among 4 groups(P >0.05).Multiple linear stepwise regression analysis showed that age,diastolic blood pressure were common risk factors of T3 and thyroid hormone(T4),while total bilirubin(TBIL),direct bilirubin(DBIL),creatinine(Cr),high density lipoprotein cholesterol(HDL C)and low density lipoprotein cholesterol(LDL C)were risk factors influencing FT4.Conclusion The very elderly hypertensive patients had the lowest levels of T3 and FT3 and the highest level of T4.The influencing factors of T3 and FT3 were age and diastolic blood pressure.The influencin

关 键 词：原发性高血压 老老年人 甲状腺功能 总胆红素 肌酐 血脂 影响因素 

分 类 号：R541.1[医药卫生—心血管疾病] R255.3[医药卫生—内科学]