摘要
目的研究亚临床甲状腺功能减退症(甲减)与脑梗死患者颅内动脉粥样硬化的联系和可能存在的发病机制,为脑梗死高危人群的预防和干预提供可靠数据支持。方法选取2016年3月至2017年2月该院神经内科一病区收治的脑梗死住院患者157例作为研究对象,其中出现亚临床甲减[促甲状腺激素(TSH)>4.50mIU/L]70例。以TSH 10mIU/L为切点分为轻度亚临床甲减(SCH1)组(TSH<10mIU/L,46例)和重度亚临床甲减(SCH2)组(TSH≥10mIU/L,24例),比较2组患者各种动脉硬化指标的变化,同时,分析不同TSH水平与各种动脉硬化指标的相关性。结果与SCH1组患者比较,SCH2组患者低密度脂蛋白(LDL)、载脂蛋白(b)[Apo(b)]、同型半胱氨酸(Hcy)水平均明显升高,差异均有统计学意义(P<0.05)。TSH与LDL、Apo(b)、Hcy呈明显正相关性(P<0.05)。TSH与LDL、Hcy、游离甲状腺素存在线性关系(P<0.05)。结论脑梗死合并亚临床甲减患者血清TSH水平升高与LDL、Apo(b)、Hcy具有一定相关性。长期的亚临床甲减患者通过影响体内脂质代谢和高水平Hcy等动脉硬化危险因素从而增加脑梗死发病率。
Objective To investigate the relation between subclinical hypothyroidism and intracranial atherosclerosis in the patients with subclinical hypothyroidism complicating cerebral infarction and its possible pathogenesis to provide the reliable data support for the prevention and intervention of the high-risk population of cerebral infarction. Methods One hundred and fifty-seven inpatients with cerebral infarction in the first department of neurology of this hospital from March 2016 to February 2017 were selected as the study subjects.Among them 70 cases appeared the subclinical hypothyroidism(TSH>4.50 mIU/L).With TSH=10 mIU/L as the cutting point,the cases were divided into the slight subclinical hypothyroidism group(SCH1,TSH<10 mIU/L,46 cases) and severe subclinical hypothyroidism group(SCH2,TSH≥10 mIU/L,24 cases) group.Then the changes of various atherosclerosis clinical indicators were compared between the two groups.Meanwhile the correlation between different TSH levels with various atherosclerosis clinical indicators was analyzed. Results Compared with the SCH1 group,the levels of LDL,Apo(b) and homocysteine(Hcy) in the SCH2 group were increased significantly,and the difference was statistically significant( P <0.05).TSH had the linear relationship with LDL,Hcy and free thyroxine( P <0.05). Conclusion The increase of serum TSH level in the patients with cerebral infarction complicating subclinical hypothyroidism has a certain correlation with LDL,Apo(b) and Hcy.The patients with long term subclinical hypothyroidism increase the occurrence rate of cerebral infarction by affecting body lipid metabolism and atherosclerosis risk factors such as high level Hcy.
作者
李英
田青
韩燕丽
乔煦
LI Ying;TIAN Qing;HAN Yanli;QIAO Xu(Department of Clinical Laboratory, Nanyang Nanshi Hospital,Nanyang,Henan 473000,China;First department of Neurology, Nanyang Nanshi Hospital,Nanyang,Henan 473000,China)
出处
《现代医药卫生》
2019年第7期1014-1016,共3页
Journal of Modern Medicine & Health
