甲减及亚临床甲减患者的血脂变化研究

Research on Hypothyroidism and Subclinical Hypothyroidism in Patients with Lipids Change

目的观察研究甲状腺功能减退症(甲减)及亚临床甲状腺功能减退症(亚临床甲减)患者血脂的状况,并分析亚临床甲减患者促甲状腺素(TSH)值与血脂间的关系。方法收集2012年1月至2012年6月在我院分泌科门诊及病房就诊的患者279名,分为甲减组、亚临床甲减组,并收集同期在我科门诊或病房检查甲状腺功能正常者86例作为对照组,比较各组血脂指标的变化;将亚临床甲减组按TSH分层(分为TSH4.78～10μIU/L和TSH>10μIU/L)后与正常对照组比较。结果甲减组总胆固醇(CHO)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)高于对照组,高密度脂蛋白胆固醇(HDL-C)低于对照组,均有显著性差异;亚临床甲减组CHO、LDL-C均明显高于对照组,有显著性差异;分层后,TSH4.78～10uIU/L亚临床甲减组CHO与对照组有升高趋势,但无统计学差异,TSH>10uIU/L亚临床甲减组CHO、TG、LDL-C均明显高于对照组,有显著性差异。结论甲减及亚临床甲减患者血脂明显升高,且亚临床甲减患者血脂升高与TSH值升高有关,临床应予重视。

Objective To study and observe subclinical hypothyroidism （subclinical hypothyroidism） and the hyperlipidemia status in patients with clinical thyroid function hypothyroidism （clinical hypothyroidism）, and analysis the relationship between subclinical hypothyroidism TSH values and lipids. Methods Collected 279 patients from January 2012 to June 2012 in our hospital outpatient clinics and wards for treatment, divided them into hypothyroidism, subclinical hypothyroidism, and collected 86 patients over the same period in the outpatient ward or checknormal thyroid function as a constrast group. FT3, FT4, TSH, CHO, TG, HDL-C, LDL-C and other indicators in each group were detected, then their changes in the indicators were compared between the normal constrast group and subclinical hypothyroidism which were divided into layer TSH4.78-10ulU/L and TSH〉I 0ulU/L according thire TSH values before. Results Hypothyroidism group CHO, TG, LDL-C higher than that of the control group, HDL-C lower than that of the control group, there were significant differences; subclinical hypothyroidism group CHO, and LDL-C were significantly higher than that of the control group, there were significant differences; CHO of stratified TSH4.78-10ulU/L subclinical hypothyroidism group ended to increase compariing the control group, but no significant difference; but CHO, TG, LDL-C in TSH〉 10uIU/L subclinical hypothyroidism group were significantly higher than those of the control group, there were significant differences. Conclusion Hyperlipidemia was significantly higher in patients with hypothyroidism and subclinical hypothyroidism, and elevated blood lipids in patients with subclinical hypothyroidism is related to elevated TSH values, so it must be given adequate attention in clinical.