亚临床甲状腺功能减退对老年高血压病患者颈动脉粥样硬化的影响

目的 探讨亚临床甲状腺功能减低(亚甲减)对老年高血压病患者颈动脉粥样硬化的影响.方法 未系统治疗的286例老年高血压病患者为研究对象,根据病情将其分为高血压合并亚甲减组(31例)及单纯高血压病组(255例).2组患者均常规测定收缩压、舒张压、身高、体重、空腹血糖、血肌酐、血尿酸、血脂、甲状腺功能及颈动脉内-中膜厚度,计算体质指数.应用单因素分析和Logistic多元回归分析方法分析上述各指标以及吸烟史与颈动脉粥样硬化的关系.结果 高血压合并亚甲减组的颈动脉内-中膜厚度较单纯高血压病组厚(2.2±1.1)mm比(1.8±0.7)mm,P＜0.05],舒张压水平、TG、血清促甲状腺激素水平均较单纯高血压病组高(82 ±11)mm Hg(1 mm Hg=0.133 kPa)比(78 ±11)mm Hg,(2.1±1.3)mmol/L比(1.7±1.0) mmol/L,(10.5±17.3) mIU/L比(2.0±1.1)mIU/L,P＜0.01或P＜0.05]；Logistic多元回归分析结果显示,随吸烟史增长,TG、舒张压、血清促甲状腺激素水平增高,颈动脉内-中膜厚度增厚.结论 老年高血压病患者在通过超声测定颈动脉内-中膜厚度的同时应行甲状腺功能检测,以更好地预测心血管疾病的发生发展.

The effect of subclinical hypothyroidism on carotid atherossclerosis in elderly hypertensive patients

Objective To investigate the effect of subclinical hypothyroidism on the thickness of the intimamedia of the carotid wall in elderly hypertensive patients. Methods Patients with high blood pressure in Beijing Anzhen hospital from Oct. 2008 to Jun. 2011 were divided into two groups： the group of hypertension with subclinical hypothyroidism and the group of hypertension. Patients in each group were 31 cases and 255 cases respectively. Systolic blood pressure, diastolic blood pressure, height, weight, fasting blood glucose, serum creatinine, uric acid, blood lipid level, carotid intima-media thickness and thyroid function were tested. The body mass indexes were calculated. Results The carotid intima-media thickness in the group of hypertension with subclinical hypothy- roidism was thicker than that in the hypertensive group （ 2.2 ± 1.1 ）mm vs （ 1.8 ± 0.7 ） mm, P 〈 0.05 ]. The levels of diastolic blood pressure, triglyeerides, serum thyroid hormone in the group of hypertension with subclinical hypothyroidism were higher than those in the hypertensive group （82±11 ）mm Hg（ 1 mmHg = 0. 133 kPa） vs （78± 11 ）mm Hg, （2.1 ±1.3） mmoL/L vs （1.7 ±1.0）retool/L, （10± 17） mIU/L vs （2.0±1. 1） mIU/L, P 〈0.01 or P 〈0, 05 ]. Logistic Multiple regression analysis showed that with the growth history of smoking, the levels of triglyceride, diastolic blood pressure, serum thyroid hormone, carotid artery intima-media thickness were increased. Conclusion The measurement of the carotid artery and the tests of thyroid function are needed in elderly hypertensive patients.