摘要
目的 探讨左旋甲状腺素与阿托伐他汀联合使用对亚临床甲状腺功能减退症(sublclinical hypothyroidism,SCH)患者甲状腺功能(简称甲功)及血脂的影响。方法 选择2016年1月—2021年11月我院收治的84例轻度SCH患者和96例重度SCH患者,随机分为L-T4亚组和联合亚组。L-T4亚组单用左旋甲状腺素治疗,联合亚组在其基础上加用阿托伐他汀。比较两组患者的甲功及血脂改善情况。结果 联合亚组和L-T4亚组治疗后游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)升高,促甲状腺激素(thyroid stimulating hormone,TSH)下降,与治疗前相比差异有统计学意义(P<0.05)。联合亚组和L-T4亚组治疗后甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇-C(low density lipoprotein cholesterol,LDL-C)下降,高密度脂蛋白胆固醇-C(high density lipoprotein cholesterol,HDL-C)升高,与治疗前相比差异有统计学意义(P<0.05)。在轻度SCH患者中,联合亚组和L-T4亚组治疗后TG、TC、LDL-C、HDL-C差异无统计学意义(P>0.05);而在重度SCH患者中,联合亚组治疗后TC、LDL-C低于L-T4亚组,差异有统计学意义(P<0.05),而联合亚组和L-T4亚组治疗后TG、HDL-C差异无统计学意义(P>0.05)。结论 单纯左旋甲状腺素替代治疗一定程度上可以改善轻度及重度SCH患者的血脂;但在重度SCH患者中,联合阿托伐他汀治疗效果更加显著。
Objective To investigate the effect of levothyroxine combined with atorvastatin on thyroid function and blood lipids in patients with subclinical hypothyroidism(SCH).Methods A total of 84 mild SCH patients and 96 severe SCH patients admitted to our hospital from January 2016 to November 2021 were randomly divided into L-T4 subgroup and combined subgroup.L-T4 subgroup was treated with levothyroxine alone,and atorvastatin was added to the combined subgroup.The improvement of thyroid function and blood lipids between two groups of patients were compared.Results After treatment,FT,,FT4 significantly increased,while TSH significantly decreased in both subgroups compared to those before treatment(P<0.05).After treatment,TG,TC,LDL-C significantly decreased and HDL-C significantly increased in both subgroups compared to those before treatment(P<0.05).In mild SCH patients,there was no significant difference in TG,TC,LDL-C,and HDL-C between the combined subgroup and the L-T4 subgroup after treatment(P>0.05).In severe SCH patients,the TC and LDL-C levels in the combined subgroup were significantly lower than those in the L-T4 subgroup after treatment(P<0.05),while there was no significant difference in TG and HDL-C levels between the combined subgroup and the L-T4 subgroup after treatment(P>0.05).Conclusion Simple levothyroxine replacement therapy can improve the blood lipid in mild and severe SCH patients to some extent.However,in severe SCH patients,the combination of levothyroxine and atorvastatin is more effective.
作者
刘彦秀
任美玲
费翔
崔建春
鲁丽
LIU Yanxiu;REN Meiling;FEI Xiang;CUI Jianchun;LU Li(People's Hospital of China Medical University/Liaoning Provincial People's Hospital,Shenyang 110067,Liaoning Province,China;Chaoyang Second Hospital)
出处
《中国实用乡村医生杂志》
2023年第4期69-71,75,共4页
Chinese Practical Journal of Rural Doctor
基金
辽宁省自然科学基金项目,项目编号:2020-MS-050。
