原发性甲减患者应用左旋甲状腺素治疗后血脂、心肌酶谱的变化

目的观察原发性甲减患者应用左旋甲状腺素治疗后血脂、心肌酶谱的变化。方法原发性甲减患者30例，在诊断初和经左旋甲状腺素治疗4周时分别测定空腹血清FT3、FT4、TSH、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、门冬氨酸氨基转移酶（AST）、肌酸激酶（CK）、乳酸脱氨酶（LDH）及其同功酶HBDH。结果治疗前，TC、LDL-C水平与FT3、FT4、TSH水平显著相关，而TG水平与甲状腺功能无相关性；心肌诸酶水平与甲状腺功能显著相关。冶疗后，血清TC水平下降44．6％（P〈0．01），LDL-C下降39．3％（P〈0．01），TG下降27．1％（P〉0．05）。血清CK、AST、LDH及HBDH平均下降幅度则分别为79．3％、51．0％、37．9％、38．2％（P均〈0．01）。结论原发性甲减患者应用左旋甲状腺素治疗可显著降低胆固醇、甘油三酯、低密度脂蛋白与心肌诸酶水平。

Changes of blood lipid profile,myocardial enzymes after levothyroxine treatment in the patients with primary hypothyroidism

Objective To evaluate the changes in blood lipids,myocardial enzymes after levothyroxine treatment in the patients with primary hypothyroidism.Methods Thirty patients with primary hypothyroidism were recruited.All patients were examined before and 4 weeks after levothyroxine treatment.Fasting blood FT_3,FT_4,TSH,total cholesterol(TC),triglycerides(TG),aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydrogenase(LDH)and its isoenzyme(HBDH)were determined.Results Before treatment,TC and LDL-C levels were significantly correlated with FT_3,FT_4 and TSH levels,meanwhile,TG level was not associated with thyroid function.In addition,CK,AST,LDH and HBDH levels were significantly correlated with thyroid function.After therapy for 4 weeks,TC level decreased by 44,6%(P<0.01),TG level decreased by 27.1%(P<0.05),and LDL-C level dropped by 39.3%(P<0.01).The reduction in CK,AST,LDH and HBDH averaged 79.3%,51.0%,37.9% and 38.2%(all P<0.01),respectively.Conclusion The administration of levothyroxine to patients with primary hypothyroidism makes the elevated myocardial enzymes and TC,TG,LDL-C levels decreased.