甲状腺功能正常的桥本氏病患者肱动脉内皮依赖性血管舒张功能研究

Impairment of Endothelium-dependent arterial dilation in Hashimoto's Thyroiditis Patients with Euthyroid State

目的探讨甲状腺功能正常的桥本氏病患者内皮依赖性血管舒张功能的变化。方法选择甲状腺功能正常的女性桥本氏病患者28例(HT甲功正常组),甲状腺功能减低的女性桥本氏病患者23例(HT甲减组)、正常女性22例(对照组)及甲状腺机能亢进症患者11例(甲亢组)。采用高分辨血管外超声法检测肱动脉内皮依赖性血管舒张功能和内皮非依赖性血管舒张功能。结果HT甲功正常组内皮依赖性血管舒张功能为3.88%,明显低于对照组的4.98%(P<0.01),而又明显高于HT甲减组3.26%(P<0.01)。同时,HT甲减组内皮依赖性血管舒张功能明显低于对照组(P<0.01)。甲亢组内皮依赖性血管舒张功能为10.42%,基础血流量为114.5 m l/m in,明显高于其它3组。4组间内皮非依赖性血管舒张功能、基础血管内径相似(P>0.05)。结论甲状腺功能正常的桥本氏病患者内皮依赖性血管舒张功能降低。

Objective To investigate the alteration of endothelial function in Hashimoto＇ s thyroiditis （HT） patients with enthyroidism. Methods This study subjects included 28 female HT patients with euthyroidism,23 female HT patients with hypothyroidism,22 healthy women ,and 11 hyperthyroid patients. High resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperaemia and after sublingual glyceryltrinitrate （GNT）. Results The flow-mediated arterial dilation among HT patients with euthyroidism was 3.88% ,which was significantly lower than that in controls （4.98%） （ P 〈 0.01 ）, and higher than that in HT patients with hypothyroidism （ 3.26% ） （ P 〈 0.01 ）. The flowmediated arterial dilation among HT patients with hypothyroidism was significantly lower than that in controis （ P 〈 0.01 ）. Meanwhile, in hyperthyroid patients,the endothelium-dependent arterial dilation and the baseline blood flow were 10.42% and 114.5 ml/min, respectively, which were significantly higher than those in other 3 groups. The GNT-induced arterial dilation, baseline vessel size were not significantly different among the three groups （ P 〉 0.05 ）. Conclusion These data show that the endothelial dysfunction exists in HT patients with euthyroidism.