亚临床甲状腺功能减退症对心血管疾病相关影响因素的临床研究

目的：探讨亚临床甲状腺功能减退症（SCH）患者血脂、血尿酸（UA）、内脂素（visfatin）、同型半胱氨酸（HCY）、超敏C反应蛋白（hs‐CRP）的变化及意义。方法将100例 SCH 患者根据促甲状腺激素（TSH ）水平分为观察 A 组（5 mIU／L ≤TSH＜10 mIU／L ，60例）和观察B组（TSH≥10 mIU／L ，40例）；对照组为健康体检者（100例）。检测患者血清 TSH、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL‐C）、低密度脂蛋白胆固醇（LDL‐C）、UA、HCY、hs‐CRP、visfatin水平并进行分析。结果观察A组患者血TG、visfatin水平与对照组比较，差异均有统计学意义（P＜0．05）；观察B组患者血 TG、visfatin、LDL‐C、UA、HCY、hs‐CRP水平均较与对照组明显增高（P＜0．05），并以 TG、visfatin升高最为显著（P＜0．01）。但A、B两组患者血HDL‐C水平与对照组比较，差异均无统计学意义（P＞0．05）。结论 SCH患者脂质代谢紊乱和高尿酸血症可能是促发动脉粥样硬化的重要危险因素；HCY、hs‐CRP、visfatin可作为SCH患者动脉粥样硬化程度的预测指标。

The clinical study on risk factors for cardiovascular diseases in patients with subclinical hypothyroidism

Objective To investigate the changes and significance of risk factors (blood lipid ,UA ,visfatin ,HCY and hs CRP) for cardiovascular diseases in patients with subclinical hypothyroidism(SCH) .Methods One hundred patients with SCH were divided into observation group A (5 mIU/L≤TSH<10 mIU/L ,n=60) and observation group B (TSH≥10 mIU/L ,n=40) in accordance with thyroid stimulating hormone (TSH ) level .The control group included one hundred healthy individuals .We measured the factors of cardiovascular diseases such as TSH ,total cholesterol (TC) ,triglyceride (TG) ,high density lipoprotein cholesterol (HDL‐C) ,low density lipoprotein cholesterol (LDL‐C) ,serum uric acid (UA) ,visfatin ,homocysteine (HCY) and high sensitive C‐reactive protein (hs‐CRP) and visfatin level .Results The levels of TG and visfatin of observation groups were signifi‐cantly higher than control group (P<0 .05) .In group B ,levels of TG ,visfatin ,LDL‐C ,UA ,HCY and hs‐CRP were much more sig‐nificantly higher than control group(P<0 .05) ,and TG and visfatin had the most significant increase (P<0 .01) ,and there were no significant different in HDL‐C in group A and B(P>0 .05) .Conclusion In Subclinical hypothyroidism patients ,lipid disorders and hyperuricemia are the risk factors of thyroid nodules and coronary heart disease .HCY ,hs‐CRP and visfatin should be used as the indicators to evaluate the cardiovascular risk .