亚临床甲状腺功能减低患者血脂及血尿酸改变的临床分析

目的探讨亚临床甲状腺功能减低患者血脂、血尿酸水平变化及其可能原因。方法收集2008年2月至2011年6月诊断为甲状腺功能减低（甲减组）患者21例，亚临床甲状腺功能减低（亚甲减组）患者25例，体检甲状腺功能正常者（对照组）20例，同时测定各组TC、TG、LDL—c、HDL—c、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、血尿酸水平。结果①与对照组比较，甲减组及亚甲减组促甲状腺激素（TSH）水平明显增高，差异有统计学意义（P〈0．01），甲减组TSH较亚甲减组增高，差异有统计学意义，P〈0．05；②与对照组比较，甲减组及亚甲减组患者的TG、TC、LDL、ApoB、尿酸升高，HDL减低，差异有统计学意义（P〈0．05或P〈0．01）；与亚甲减组比较，甲减组患者HDL、ApoA减低，TG、TC、LDL、ApoB、尿酸升高，差异有统计学意义（P〈0．05或P〈0．01）；③TsH与TC、TG、HDL、LDL、ApoA、ApoB、血尿酸均呈正相关（r值分别为0．781、0．686、0．648、0．341、0．429、0．519、0．351，均P〈0．01），FT3与TC、TG、HDL、LDL、ApoA、ApoB、血尿酸均呈负相关（r值分别为-0．723、-0．641、-0．716、-0．327、-0．415、-0．571、-0．368，均P〈0．01），n与TC、TG、HDL、LDL、ApoA、ApoB、血尿酸均呈负相关（r值分别为-0．742、-0．-675、-0．697、-0．317、-0．403、-0．537、-0．324，均P〈0．01）。结论亚临床甲状腺功能减退患者的血脂异常及血尿酸改变的原因可能与甲状腺激素的水平及其功能，TSH水平均有关系，因此在亚临床甲状腺功能减退阶段，合理的应用甲状腺素对于防治心血管事件有重要的意义。

Analysis of the variety of lipids and blood uric acid in patients with subclinical hypothyroidism

Objective To analyze the variety of lipids and blood uric acid in patients with subclinical hypothyroidism. Methods Twenty-one cases of hypothyroidism and 25 cases of subclinical hypothyroidism were selected as hypothyroidism group and subclinical hypothyroidism. 20 healthy volunteers were regarded as a control group. The levels of thyroid stimulating hormone （ TSH ） , freetriiodothyronine （ FT3 ） , free thyroxine （ FT4 ）, total cholesterol （ TC ）, triglyceride （ TG）, low density lipoprotein （ LDL-C ）, high density lipoprotein （ HDL-C ）, apohpoprotein A, apohpoprotein B and uric acid （UA）were measured and analyzed. Results Compared with control subjects, the level of TSH in hypothyroidism group and subclinical hypothyroidism group was increasing remarkably （P 〈 0.01 ）, and the level of TSH between hypothyroidism and subclinical hypothyroidism group was significantly different （ P 〈 0.05 ）. Compared with control subjects, patients with subclinical hypothyroidism as well as patients with hypothyroidism had higher TSH, TC, TG, LDL-C, apohpoprotein B and UA. Lower HDL-C in hypothyroidism group was significantly different （ P 〈 0.05, 0.01 ）. The level of TSH was positively correlated with increasing TC, TG, LDL-C, apohpoprotein B, UA and lower HDL-C （ P 〈 0.01 ） ; the level of FT3 and FT4 was negatively correlated with increasing TC, TG, LDL-C, apohpoprotein B, UA and lower HDL-C （ P 〈 0. 01 ）. Conclusions The variety of lipids and blood uric acid in patients with subclinical hypothyroidism may he related with the level of FT3, FT4 and its function or the level of TSH.