亚临床甲状腺功能减退症患者血清同型半胱氨酸和脂蛋白(a)水平变化及临床意义

目的观察亚临床甲状腺功能减退症(亚临床甲减)患者经甲状腺激素治疗前后血清同型半胱氨酸(Hcy)及脂蛋白(a)[Lp(a)]的浓度变化,寻找亚临床甲减与其之间的关系。方法选择2009年1月至2012年9月来院就诊的亚临床甲减患者36例(其中门诊患者25例,住院患者11例),分别在初诊和左旋甲状腺激素治疗8～12周后观察甲状腺功能(FT3、FT4及TSH)、血清Hcy及Lp(a)水平的变化。结果患者甲状腺功能恢复正常后,血清Hcy及Lp(a)水平较治疗前相比下降,差异有统计学意义(P<0.05)。结论甲状腺素替代治疗可降低亚临床甲减患者血清增高的Hcy及Lp(a)水平。

The changes and its clinical value of serum homocysteine and lipoprotein(a) in patients with subclinical hypothyroidism before and after levothyroixine repacement treatment

Objective To investigate the serum levels of homocysteine(Hcy) and lipoprotein(a)[ Lp(a)] in patients with subclinical hypothyroidism before and after levothyroxine replacement therapy.Methods Thirty-six patients with subclinical hypothyroidism(including 25 outpatients and 11 inpatients) were observed from January 2009 to September 2012.The serum levels of FT3,FT4,TSH,Hcy and Lp(a) were detected before and after levothyroxine replacement therapy for 8 to 12 weeks.Results The serum levels of Hcy and CysC were significantly decreased with the recovery of thyroid function after substitutional treatment with levothyroxine,and the difference was statistically significant(P<0.05).Conclusion Levothyroxine replacement therapy can decrease the increased serum Hcy and Lp(a) levels in patients with subclinical hypothyroidism.