轻度甲状腺功能异常对血清半胱氨酸蛋白酶抑制蛋白C水平的影响

目的探讨轻度甲状腺功能异常对血清半胱氨酸蛋白酶抑制蛋白C（cystatin C，Cyst C）水平的影响。方法测定诊断为亚临床型甲状腺功能低下及亢进患者的血清CystC含量，同时检测两组患者TSH恢复正常时血清Cyst C水平的变化。结果研究对象包括26例亚临床型甲状腺功能低下患者及14例亚临床型甲状腺功能亢进患者。亚临床型甲状腺功能低下组在左旋甲状腺素治疗前后的TSH分别为7．8（4．3-26．7）mU／L和2．3（0．36—4．0）mU／L。同时血清CystC含量由（0．72±0．18）mg／L升高至（1.1±0．3）mg／L，差异具有统计学意义（P〈0．01）。亚临床型甲状腺功能亢进组诊断时TSH均值为0．06（0．001-0．25）mU／L，当甲状腺功能恢复正常时为1．6（0．28-4．0）mU／L。同时CystC水平则由（1．08±0．31）mg／L下降至（0．91±0．30）mg／L，差异有统计学意义（P〈0．05）。结论轻度甲状腺功能异常对血清CystC含量有显著影响，因此在用CystC反映肾功能变化的同时应考虑到是否有甲状腺功能异常对血清CystC水平产生的影响。

Impact of Mild Thyroid Disorders on Serum Cystatin C

Objective To investigate the impact of mild thyroid disoders on serum cystatin C （ Cyst C）. Methods Cyst C was assayed at the time of diagnosis of subelinical hypo-and hyper-thyroidism in 40 patients with mild thyroid disoders, and its ehange was deteeted when TSH returned to normal. Results Twenty-six patients with subclinieal hypothyroidism and 14 ones with subelinieal hyperthyroidism were ineluded. The TSH median of the patients with subelinieal hypothyroidism was 7.8 （4.3 - 6.7 ） mU/L （ before treatment） and deereased to 2.3 （ 0.36 - 4.0 ） mU/L （ after treatment with levothyroxine ） ; mean Cys C level Jnereased from 0.72 ± 0.18 mg/L to 1.1± 0.3 mg/L when TSH was normalized （ P 〈 0.01 ）. In the patients with subelinieal hyperthyroidism, the TSH median was 0.06 （0. 001 -0.25 ） mU/L and inereased to 1.6 （0.28 -4.0） mU/L; Cyst C deelined from 1.08 ± 0.31 mg/L to 0.91 ± 0.30 mg/L （ P 〈0. 005 ）. Conclusion Serum Cyst C ean be signifieantly changed by mild disoders, and thyroid funefion has to be eonsidered when Cyst C is used as a marker of kidney funefion.