凝血纤溶活性检测对甲减病情程度的预测价值

Predictive Value of Coagulative-fibrinolytic Activity Detection for Serious Extent of Hypothyroidism

目的研究凝血纤溶活性检测对甲状腺功能减退(甲减)病情程度的预测价值。方法选择2014年4月至2015年4月我院70例甲减患者作为观察组,再根据促甲状腺激素(TSH)水平将患者分为轻度甲减组与重度甲减组,另选择同一时期60例来我院体检健康合格者最为对照组,采用酶联免疫吸附双抗体夹心法检测三组D二聚体(DD)、纤维酶原激活物抑制剂-1(PAI-1)、凝血酶激活的纤溶抑制物(TAFI)、纤维蛋白原(Fbg)及组织型纤溶酶原激活物(t-PA)凝血纤溶活性及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C),分析其在诊断和预测甲减病情严重程度中的应用价值。结果轻度甲减患者D-D低于对照组,PAI-1、TAFI、Fbg及t-PA高于常规对照组,重度患者D-D为高于对照组,PAI-1、TAFI、Fbg及t-PA低于对照组,差异有统计学意义(P<0.05)。三组TC、TG及LDL-C等血脂水平比较,差异有统计学意义(P<0.05)。结论甲状腺功能减退对机体凝血纤溶系统具有显著影响,检测凝血纤溶指标对评估患者病情具有参考价值。

Objective To explore predictive value of coagulative-fibrinolytic activity detection for serious extent of hypothyroidism. Methods 70 cases of patients with hypothyroidism treated in our hospital from April 2014 to April 2015 were selected as the observation group, according to the thyroid stimulating hormone（TSH） levels, patients were divided into the mild hypothyroidism group and the severe hypothyroidism group, 60 volunteers who were qualified with the physical examination in our hospital at the same time were selected as the control group, enzyme linked immunosorbent assay （ELISA）was used to detect D-dimer （D- D）, plasminogen activator inhibitor- 1 （PAI- 1 ）, thrombin activator fibrinolytic inhibitor （ TAFI ）, fibrinogen （ Fbg）, tissue- type plasminogen activator （ t- PA ）, coagulative- fibrinolytic activity, total cholesterol （ TC ）, triglyceride（TG）, low density lipoprotein （LDL-C）in the three groups, its application value in diagnosis and prediction in serious extent of hypothyroidism were analyzed. Results D- D of patients with mild hypothyroidism were lower than the normal control group, PAI- 1, TAFI, Fbg and t- PA were higher than the normal control group, D-D of patients with severe hypothyroidism were higher than the normal control group, PAI-1,TAFI, Fg and t-PA were lower than the normal control group （P 〈 0. 05 ）. There was a significant difference in blood lipid levels （ TC, TG and LDL- C ） in the three groups （ P 〈 0.05 ）. Conclusion Hypothyroidism has a significant effect on body coagulative-fibrinolytic system, detect coagulative-fibrinolytic indexes have high clinical application value in evaluating severity of patients.