亚临床甲状腺功能减退症与Ⅱ型糖尿病血管并发症的研究

THE RESEARCH OF SUBCLINICAL HPOTHYRODISM AND VASCULAR COMPLICATIONS IN TYPE 2 DIABETES MELLITUS

目的:探讨Ⅱ型糖尿病人颈部动脉粥样硬化与亚临床甲状腺功能减退症(Subclinical hypothyroidism,SCH)的相关性及SCH与血脂、纤维蛋白原(Fibrinogen,FIB)、平均血小板体积(mean platelet volume,MPV)等因素的关系。方法:选择住院Ⅱ型糖尿病病人326名,其中单纯Ⅱ型糖尿病病人226例,合并SCH病人100例;比较两组一般资料的差异,分析血清促甲状腺激素(thyroial strmulating hormone,TSH)与其他因素之间的相关性。结果:Ⅱ型糖尿病合并SCH组的女性、病程、颈部动脉粥样硬化患病率、总胆固醇、LDL、FIB、TSH、MPV、BMI高于单纯Ⅱ型糖尿病组,单纯Ⅱ型糖尿病组的HDL、吸烟史病人高于Ⅱ型糖尿病合并SCH组。TSH、FIB、吸烟史、性别、年龄是血管病变的危险因素。TSH与FIB、年龄、病程、总胆固醇、LDL、MPV、BMI成正相关,与性别、FT4、HDL、吸烟史成负相关。结论:Ⅱ型糖尿病合并SCH组的颈部动脉粥样硬化的所占比例高,TSH是Ⅱ型糖尿病病人颈部动脉粥样硬化的危险因素,且TSH可能通过改变血脂、FIB、MPV、BMI等因素促进Ⅱ型糖尿病血管并发症的形成。

Objective：To investigate the relationship between carotid atherosclerosis and SCH in patients with type 2 diabetes mellitus and the relationship between SCH and serum lipid,FIB,MPV and other factors.Methods：There are 326 hospitalized patients with type 2 diabetes,of which only 226 cases of patients with type 2 diabetes mellitus,type 2 diabetic patients with SCH 100 cases;we should study the difference between the two groups in the general information,analyz the correlation between the TSH and other factors.Results：In the SCH group,women,course of type 2 diabetes,carotid atherosclerosis prevalence rate,total cholesterol,LDL,FIB,TSH,MPV,BMI higher than that of type 2 diabetes mellitus,HDL and smoking history in the type 2 diabetes group was higher than that in group SCH.TSH,FIB,smoking history,gender and age are the risk factors of vascular disease.Positive correlation between TSH and FIB,age,duration,total cholesterol,LDL,MPV,BMI,FT4,HDL,sex,and smoking history are negatively correlated.Conclusion：Carotid atherosclerosis with SCH group the prevalence of type 2 diabetes is high,TSH is a risk factor for type 2 diabetes patients with carotid atherosclerosis,and the formation of TSH may through the change of blood lipid,FIB,MPV,BMI and other factors to promote vascular complications in type 2 diabetes mellitus.