亚临床甲状腺功能减退与2型糖尿病患者无症状心肌缺血的关系研究

The relationship between subclinical hypothyroidism and asymptomatic myocardial ischemia in type 2 diabetes mellitns

目的探讨亚临床甲状腺功能减退与2型糖尿病患者无症状心肌缺血之间的关系。方法回顾性分析399例成功行冠状动脉CT血管成像检查无心肌缺血症状的、无已知甲状腺疾病的2型糖尿病患者的临床资料，根据是否合并亚临床甲状腺功能减退分为亚临床甲状腺功能减退组（17例）与甲状腺功能正常组（382例），分析两组患者的临床资料、实验室检查结果及冠状动脉CT血管成像检查结果。结果2型糖尿病患者中亚临床甲状腺功能减退的发生率为4．3％（17／399），亚临床甲状腺功能减退组中男性比例及吸烟比例均低于甲状腺功能正常组，差异有统计学意义（3／17比194／382，户=0．007；2／17比136／382，P=0．043）。亚临床甲状腺功能减退组无症状心肌缺血发生5例，甲状腺功能正常组为130例，两组比较差异无统计学意义（P=0．694）。两组年龄、糖尿病病程、糖化血红蛋白、低密度脂蛋白胆固醇比较差异也无统计学意义（P〉0．05）。结论亚临床甲状腺功能减退不是2型糖尿病患者无症状心肌缺血的危险因素。

Objective To determine the relationship between subclinical hypothyroidism and asymptomatic myocardial isehemia in type 2 diabetes mellitus. Methods All of 399 asymptomatic subjects who underwent coronary CT angiography with type 2 diabetes mellitus but without thyroid disease were enrolled retrospectively. Totally patients were divided into subclinical hypothyroidism group （17 patients, type 2 diabetes mellitus with subclinical hypothyroidism ） and euthyroid group（382 patients, type 2 diabetes mellitus with normal thyroid function）. Results The incidence of subclinical hypothyroidism in type 2diabetes mellitus was 4.3%（17/399）. The ratio of male and smoking in subclinical hypothyroidism group was signifieantly lower than that in euthyroid group （3/17 vs. 194/382 ,P = 0.007 ; 2/17 vs. 136/382 ,P = 0.043 ）. The ineidenee of asymptomatie myoeardial isehemia in subelinieal hypothyroidism group was 5 eases and in euthyroid group was 130 cases, and there was no signifieant differenee（P = 0.694 ）. The age, course of type 2 diabetes mellitus, level of glyeosylated hemoglobin and low density lipoprotein eholesterol between two groups had no significant differenee（P 〉 0.05 ）. Conclusion Subclinical hypothyroidism is not an independent risk factor for asymptomatie myoeardial isehemia in type 2 diabetes mellitns.