甲状腺功能亢进症与血管内皮损伤关系的临床研究  

Clinical study on the relationship between hyperthyroidism and vascular endothelial injury

作　　者：常曼丽[1] 于天龙 景淼 高云雁 刘畅 刘岚春 苏晓辉[3] 贾海晗 刘鹏[3] Chang Manli;Yu Tianlong;Jing Miao;Gao Yunyan;Liu Chang;Liu Lanchun;Su Xiaohui;Jia Haihan;Liu Peng(Clinical laboratory,The Second Affiliated Hospital,Harbin Medical University,Harbin 150081,China;Institute of Endemic Disease Disorders,Center for Disease Control in Harbin,Harbin 150081,China;Institute of Iodine Deficiency Disorders,Center for Endemic Disease Control,Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院检验科,150081 [2]哈尔滨市疾病预防控制中心地方病预防控制所,150056 [3]哈尔滨医科大学中国疾病预防控制中心地方病控制中心碘缺乏病防治研究所,150081

出　　处：《中华地方病学杂志》2019年第11期918-921,共4页Chinese Journal of Endemiology

基　　金：国家自然科学基金(81773370);哈尔滨医科大学伍连德基金(WLD-1409)。

摘　　要：目的观察甲状腺功能亢进症(甲亢)与血管内皮损伤之间的关系。方法2016-2017年,在哈尔滨医科大学附属第二医院收集确诊为单纯性甲亢患者、自身免疫性甲状腺疾病患者、心脑血管疾病患者各60例,选取同期本院的健康体检者60例作为健康对照组。采用酶联免疫吸附试验(ELISA)法检测所有研究对象血清中血管内皮损伤指标血管性假性血友病因子(vWF)、血栓调节蛋白(TM)、内皮素-1(ET-1)、P-选择素(P-selectin)含量,并进行心脑血管疾病患者血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、抗甲状腺球蛋白抗体(TgAb)、抗甲状腺过氧化物酶抗体(TPOAb)异常率检测。对单纯性甲亢组、自身免疫性甲状腺疾病组、心脑血管疾病组和健康对照组人群的血管内皮损伤情况进行关联分析。结果健康对照组、单纯性甲亢组、自身免疫性甲状腺疾病组和心脑血管疾病组人群血清vWF、TM、ET-1、P-selectin组间比较差异有统计学意义(F=6.56、9.19、7.88、12.45,P均<0.05),且单纯性甲亢组、自身免疫性甲状腺疾病组、心脑血管疾病组4个指标均显著高于健康对照组(P均<0.05)。关联分析结果表明,单纯性甲亢组、自身免疫性甲状腺疾病组、心脑血管疾病组患者的血管内皮损伤情况与健康对照组比较,差异均有统计学意义(χ^2=5.08、5.08、8.16,P均<0.05);发生血管内皮损伤的危险性分别是健康对照组的2.37、2.37、3.07倍。心脑血管疾病组患者的TSH、FT3、FT4、TgAb、TPOAb的异常率分别为18.33%(11/60)、15.00%(9/60)、15.00%(9/60)、10.00%(6/60)、11.7%(7/60)。结论单纯性甲亢和自身免疫性甲状腺疾病是血管内皮损伤的高危因素。Objective To observe the relationship between hyperthyroidism and vascular endothelial injury.Methods From 2016 to 2017,data of 60 patients with simple hyperthyroidism,autoimmune thyroid disease,cardiovascular and cerebrovascular diseases were collected from the Second Affiliated Hospital of Harbin Medical University.And 60 healthy subjects were enrolled in the same period as a healthycontrol group.The enzyme-linked immunosorbent assay(ELISA)was used to detect the content of vascular endothelial injury markers(vWF),thrombomodulin(TM),endothelin-1(ET-1),P-selectin in serum of all subjects,as well as the serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),anti-thyroglobulin antibody(TgAb),and anti-thyroid peroxidase antibody(TPOAb)in patients with cardiovascular and cerebrovascular diseases levels.The correlation analysis of vascular endothelial injury in the simple hyperthyroidism group,autoimmune thyroid disease group,cardiovascular and cerebrovascular diseases group and healthy control group was conducted.Results There were statistically significant differences between the healthy control group,the simple hyperthyroidism group,the autoimmune thyroid disease group and the cardiovascular and cerebrovascular diseases group in the serum levels of vWF,TM,ET-1 and P-selectin,respectively(F=6.56,9.19,7.88,12.45,P<0.05),and the simple hyperthyroidism group,autoimmune thyroid disease group,cardiovascular and cerebrovascular diseases group were significantly higher than the healthy control group(P<0.05).Correlation analysis showed that the vascular endothelial injury in the patients with simple hyperthyroidism,autoimmune thyroid disease,and cardiovascular and cerebrovascular diseases groups was statistically significantly different compared with the healthy control group,respectively(χ^2=5.08,5.08,8.16,P<0.05);the risk of vascular endothelial injury in each diseased group was 2.37,2.37,and 3.07 times higher than that of the healthy control group,respectively.The abnormal rates of TSH,FT3

关 键 词：甲状腺功能 内皮损伤 心脑血管疾病 

分 类 号：R58[医药卫生—内分泌]