亚临床甲状腺功能减退患者促甲状腺素水平与缺血性脑血管病危险因素的相关性

Correlation between serum thyrotropin level and risk factors for ischemic cerebrovascular disease in patients with subclinical hypothyroidism

目的分析亚临床甲状腺功能减退(SCH)对缺血性脑血管病(ISC)相关危险因素的影响,探讨促甲状腺素(TSH)水平和ISC危险因素的关系。方法选取2018年9月至2020年9月在南京江北医院住院经诊断为ISC合并SCH的患者共61例,依据患者TSH水平分为A组21例(4.20μIU/ml≤TSH<10.00μIU/ml)和B组40例(TSH≥10.00μIU/ml);选择同期健康体检者34例作为对照组。检测并分析三组血清TSH、游离甲状腺素(FT_(4))、TG、TC、HDL-C、LDL-C、同型半胱氨酸(Hcy)、颈动脉内膜中层厚度(CIMT)水平。结果 FT_(4)水平B组稍低于A组、对照组,A组稍低于对照组,但差异无统计学意义(P>0.05);A、B两组SCH患者的CIMT均稍高于健康对照组,但差异无统计学意义(P>0.05)。TSH、TC、TG、LDL-C、Hcy水平B组高于A组、对照组,TSH、LDL-C、Hcy水平A组高于对照组,差异有统计学意义(P<0.01)。TSH和TG、TC、LDL-C、Hcy之间呈正相关关系(r=0.332、0.662、0.680、0.665,P<0.01)。结论 SCH患者更易患ISC,且TSH水平越高出现ISC的危险性越大。

Objective To explore the relationship between thyroid-stimulating hormone(TSH)and risk factors for ischemic cerebrovascular disease(ISC)in the patients with subclinical hypothyroidism(SCH).Methods A total of 61 ISC patients complicated with SCH treated from September 2018 to September 2020 were selected and divided into in group A(4.20μIU/ml≤TSH<10 μIU/ml,n=21)and group B(TSH≥10 μIU/ml,n=40)according to serum TSH level.In the same period,34 healthy people were served as c ontrol group.Serum levels of TSH,free thyroid hormone(FT_(4)),total cholesterol(TG),triglyceride(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),homocysteine(Hcy)and carotid artery intima-media thickness(CIMT)were detected and analyzed in three groups.Results Fr_(4) level was the lowest in group B,followed by group A and control group,but there was no significant difference in it among three groups(P>0.05).The CIMT of SCH patients in group A and B was slightly higher than that in healthy control group,but the difference was not significant(P>0.05).The levels of TSH,TC,TG,LDL-C and Hcy in group B were significantly higher than those in group A and control group,and the levels of TSH,LDL-C and Hcy in group A were statistically higher than those in control group(P<0.01).TSH was positively correlated with TG,TC,LDL-C and Hcy,respectively(r=0.332,0.662,0.680,0.665,P<0.01).Conclusion SCH patients are more likely to suffer from ISC and the higher the TSH level,the greater the risk of ISC.