甲状腺功能亢进症与血栓形成相关性研究进展  

Research progress on the relationship between hyperthyroidism and thrombosis

作　　者：董伟伟[1] 吴彩兰[1] DONG Weiwei;WU Cailan(Department of Nuclear Medicine,Tianjin Fourth Central Hospital,Tianjin 300140,China)

机构地区：[1]天津市第四中心医院核医学科,天津300140

出　　处：《陕西医学杂志》2021年第2期251-253,F0003,共4页Shaanxi Medical Journal

摘　　要：甲状腺功能亢进症是内分泌常见疾病之一,难治愈、易反复,对全身各个系统都有直接或间接作用。甲状腺功能亢进症影响凝血系统,较高水平的甲状腺激素可使机体处于高凝状态,凝血因子Ⅷ、Ⅸ、Ⅹ,血管性血友病因子(vWF),纤溶酶原激活物抑制剂-1含量增多,增加了动静脉血栓和致死风险,即使正常参考范围内的游离甲状腺素(FT 4)水平也与凝血因子Ⅷ、vWF有剂量相关性。心肌和血管内皮细胞有甲状腺激素作用的受体,并且对激素水平的变化很敏感。甲状腺功能亢进症诱发房颤中脑栓塞事件发生率增高,但也有甲状腺功能亢进症合并房颤患者中并未见栓塞事件风险增加的报道。动物水平研究中发现甲状腺功能亢进症可使内皮细胞损伤,可能是发生心脑血管疾病(特别是血管栓塞)的危险因素。许多细胞水平研究文章报道高碘环境可引起内皮细胞增殖和损伤,但也有研究报道高碘饮食老鼠内皮细胞未发生明显伤害。现就甲状腺功能亢进症与血栓形成相关性研究进展进行综述。Hyperthyroidism is one of the common endocrine diseases.It is difficult to cure and easy to repeat.It has direct or indirect effects on all systems of the body.Hyperthyroidism affects the coagulation system.Higher levels of thyroid hormones can make the body in a hypercoagulable state.The increase of coagulation factorsⅧ,Ⅸ,Ⅹ,von Willebrand factor(vWF),and plasminogen activator inhibitor-1 increases the risk of arteriovenous thrombosis and death.Even the free thyroxine(FT 4)level within the normal reference range is dose-related with coagulation factorⅧand vWF.Myocardium and vascular endothelial cells have receptors for thyroid hormones and are sensitive to changes in hormone levels.Hyperthyroidism induces an increased incidence of cerebral embolism in atrial fibrillation,but there are no reports of increased risk of embolism in patients with hyperthyroidism and atrial fibrillation.Animal-level studies have found that hyperthyroidism can damage endothelial cells,which may be a risk factor for cardiovascular and cerebrovascular diseases(especially vascular embolism).Many research articles at the cellular level report that high iodine environment can cause endothelial cell proliferation and damage,but there are also studies that report that the endothelial cells of rats with high iodine diet did not cause significant damage.This article reviews the research progress of the relationship between hyperthyroidism and thrombosis.

关 键 词：甲状腺功能亢进症 凝血 血栓形成 内皮损伤 血小板 纤维蛋白原 

分 类 号：R581.1[医药卫生—内分泌]