老年亚临床甲状腺功能减退患者动脉粥样硬化相关指标测定的意义

目的探讨老年亚临床甲状腺功能减退（简称亚临床甲减）患者进行动脉粥样硬化相关指标测定的意义，并对引起动脉粥样硬化的可能原因进行分析。方法比较亚临床甲减组（n=29）和对照组（n=30）的血液流变学、血脂、颈动脉内膜中层厚度（IMT）和斑块发生率。结果亚临床甲减组总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、IMT和颈动脉粥样斑块发生率高于对照组，差异均有统计学意义（t分别=5.34、3．77、3．05，x^2=6．59，P均〈0．05），而两组间高密度脂蛋白（HDL）、甘油三脂（TG）、载脂蛋白A（ApoA）比较，差异均无统计学意义（t分别=1．06、-0．53、0．31，P均〉0．05）；两组间全血粘度（高切、低切）、血浆粘度、纤维蛋白原比较，差异均无统计学意义（t分别=-1．19、1．01、-1．35、-1．23，P均〉0．05）。结论亚临床甲减时动脉粥样硬化的发生可能与脂代谢异常有关。但未发现与全血粘度、血浆粘度和纤维蛋白原有相关性。亚临床甲减会升高动脉粥样硬化的发病率。

Significance of atherosclerosis-related indicators in elderly patients with subclinical hypothyroidism

Objective To investigate the significance of atherosclerosis-related indicators in the aged with subclinical hypothyroidism and analyze the possible reasons that caused atherosclerosis. Method Incidence of hemorheology, blood lipid and carotid intima-media thickness （IMT） and plaque between subclinical hypothyroidism group （n=29） and control group （n=30） were compared. Results Cholesterol （TC）, low density lipoprotein cholesterol （LDL-C） , IMT and plaque in subclinical hypothyroidism group were higher than control group. The differences were statistically significant （t = 5.34,3.77,3.05 ,X^2 =6.59, P〈0.05）. There was no significant difference of high-density lipoprotein （HDL）, triglycerides （TG）, apolipoprotein A （ApoA）between two group（t = 1.06,-0.53,0.31, P〉0.05） .The whole blood viscosity （high shear, low shear）, plasma viscosity, and fibrinogen between the two groups had no significant differences （t=-1.19,1.01,-1.35,-1.23,P〉0.05）. Conclusions Atherosclerosis in subclinical hypothyroidism patients may be associated with the abnormal lipid metabolism and may not be correlated with whole blood viscosity, plasma viscosity and fibrinogen. Subclinical hypothyroidism may increase the incidence of atherosclerosis.