甲状腺抗体水平对颈动脉粥样硬化斑块的影响

Effects of thyroid antibody level with carotid atherosclerotic plaque

目的探讨甲状腺抗体水平对颈动脉粥样硬化斑块的影响。方法选取2019年7月至2022年5月中国人民解放军联勤保障部队第九六〇医院收治的492例急性脑梗死患者作为研究对象,依据颈动脉血管超声检查结果分为无斑块组125例、有斑块组367例(易损斑块组215例、稳定斑块组152例),比较不同组别促甲状腺激素(thyroid stimulating hormone,TSH)、游离甲状腺素(free thyroxin,FT_(4))、游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroid globulin antibody,TGAb)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、同型半胱氨酸(homocysteine,HCY)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的差异。结果有斑块组TPOAb、TGAb、LDL-C、hs-CRP水平均高于无斑块组,差异有统计学意义(P<0.05);两组在性别、TSH、FT_(4)、FT_(3)、TC、HCY、是否吸烟,以及是否有高血压、糖尿病、冠心病等方面比较,差异无统计学意义(P>0.05)。Logistic回归分析结果显示,TPOAb、TGAb、LDL-C和hs-CRP是颈动脉粥样硬化斑块的独立危险因素(P<0.05)。与稳定斑块组比较,易损斑块组TPOAb、TGAb、TSH、hs-CRP水平较高,差异有统计学意义(P<0.05);两组在年龄、性别、FT_(4)、FT_(3)、TC、LDL-C、HCY、是否吸烟,以及是否有高血压、糖尿病、冠心病等方面比较,差异无统计学意义(P>0.05)。Logistic回归分析结果显示,TGAb、hs-CRP是颈动脉粥样硬化斑块稳定性的独立危险因素(P<0.05)。结论急性脑梗死患者血清TPOAb、TGAb水平升高与颈动脉粥样硬化斑块的发生发展有关。

Objective To determine the effect of the thyroid antibody level on carotid atherosclerotic plaque.Methods A total of 492 patients with acute cerebral infarction who were admitted to the 960th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force from July 2019 to May 2022 were selected as study participants.Based on the results of carotid vascular ultrasonography,the patients were divided into no-plaque(n=125)and plaque groups[n=367(vulnerable plaque group,n=215;and stable plaque group,n=152)].The following laboratory test results were compared between the two groups:thyroid stimulating hormone(TSH),free thyroxine(FT_(4)),free triiodothyronine(FT_(3)),thyroid peroxidase antibody(TPOAb),thyroid globulin antibody(TGAb),total cholesterol(TC),lowdensity lipoproteincholesterol(LDL-C),homocysteine(HCY),and high-sensitivity C-reactive protein(hs-CRP).Results The TPOAb and TGAb titers,and LDL-C and hs-CRP levels in the plaque group were higher than the no-plaque group(P<0.05).There were no significant differences in the gender,TSH,FT_(4),FT_(3),TC,HCY,hypertension,diabetes,coronary heart disease and smoking between the two groups(P>0.05).Logistic regression analysis showed that the TPOAb and TGAb titers,and LDL-C and hs-CRP levels were independent risk factors for carotid atherosclerotic plaque(P<0.05).The TPOAb and TGAb titers,and TSH and hs-CRP levels in the vulnerable plaque group were increased compared to the stable plaque groups(P<0.05).There were no significant differences in the age,gender,FT_(4),FT_(3),TC,LDL-C,HCY,hypertension,diabets,coronary heart disease and smoking between the two groups(P>0.05).Logistic regression analysis showed that the TGAb titer and hs-CRP level were independent risk factors for carotid atherosclerotic plaque stability(P<0.05).Conclusions The increase in serum TPOAb and TGAb levels in patients with acute cerebral infarction is associated with the occurrence and development of carotid atherosclerotic plaque.