老年原发性甲状腺功能减退症120例临床分析

Clinical analysis of 120 elder cases with primary hypothyroidism

目的:探讨老年原发性甲状腺功能减退症的临床特点、治疗方法及临床疗效。方法:选择我院2009年12月～2010年8月收治的120例老年原发性甲状腺功能减退症的患者作为甲减组,分析其临床特点,120例患者采用替代疗法治疗。另选取同期健康体检的40例正常者作为对照组,比较甲减组治疗前、后和对照组的游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、超敏促甲状腺激素(sTSH)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平及血液流变学指标血浆黏度值、纤维蛋白原、血红蛋白。结果:甲减患者多有一些非特异性表现,甲减组治疗前sTSH、TC、TG、LDL-C、血浆黏度值、纤维蛋白原、血红蛋白显著高于对照组(P<0.05),FT3、FT4显著低于对照组(P<0.05),治疗后甲减组以上各指标均恢复正常,与对照组差异无统计学意义(P>0.05)。结论:替代治疗可改善甲减患者的血脂水平和血浆黏度,促进患者甲状腺功能的恢复。

Objective. To explore clinical character, treatment and therapeutical effect of elder primary hypothyroidism. Methods： A total of 120 elder cases with primary hypothyroidism admitted from December 2009 to August 2010 were selected, and were treated with replacement therapy; while another 40 healthy people were selected as control group. Tree triiodothyronine （FT3）, free thyroxine （FT4）, hypersensitive thyroid stimulating hormone （sTSH）, total cholesterol （TC）, triglyceride; triglyeride （TG）, low density lipoprotein （LDL-C） and hemorheological indexes including blood plasma viscosity, fibrinogen and hemoglobin before and after treatment were determined. Results：Patients with hypothyroidism had non-specific characteristics. Before treatment, sTSH, TC, TG, LDL-C, blood plasma viscosity, fibrinogen and hemoglobin were significantly higher in hypothyroidism patients than those of control group （P〈 0.05）, while levels of FT3 and FT4 were significantly higher（P〈0.05）. Conclusions： Replacement therapy can improve blood lipid status and blood plasma viscosity, and promote the recovery of thyroid function.