CAJ | 학술논문

目的：探讨亚临床甲状腺功能减退症（亚临床甲减）患者外周血中血小板参数和凝血4项的变化及其临床意义。方法选择解放军532医院2011年3月至2013年3月健康体检中心体检人员90例为研究对象，通过电化学发光免疫法测定血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）水平，根据FT3、FT4和TSH水平将研究对象分为轻度亚临床甲减组、重度亚临床甲减组及健康对照组各30例。测定各组血小板计数（PL T ）、血小板平均体积（M PV ）和血小板分布宽度（PDW ），以及凝血酶原时间（PT ）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（FIB）。结果3组患者 PLT差异无统计学意义（P＞0．05）；与对照组相比，重度亚临床甲减组MPV及PDW升高，PT、APTT 和 TT 时间延长，FIB升高，差异具有统计学意义（P＜0．05）；而轻度亚临床甲减组各项指标与健康对照组相比差异无统计学意义（P＞0．05）。结论重度亚临床甲减患者PT、APTT及TT时间延长提示凝血功能减退，而MPV、PDW及FIB升高提示凝血功能亢进，这种变化可能是导致心血管疾病发生的诱因。
목적：탐토아림상갑상선공능감퇴증（아림상갑감）환자외주혈중혈소판삼수화응혈4항적변화급기림상의의。방법선택해방군532의원2011년3월지2013년3월건강체검중심체검인원90례위연구대상，통과전화학발광면역법측정혈청유리삼전갑상선원안산（FT3）、유리갑상선소（FT4）화촉갑상선격소（TSH）수평，근거FT3、FT4화TSH수평장연구대상분위경도아림상갑감조、중도아림상갑감조급건강대조조각30례。측정각조혈소판계수（PL T ）、혈소판평균체적（M PV ）화혈소판분포관도（PDW ），이급응혈매원시간（PT ）、활화부분응혈활매시간（APTT）、응혈매시간（TT）화섬유단백원（FIB）。결과3조환자 PLT차이무통계학의의（P＞0．05）；여대조조상비，중도아림상갑감조MPV급PDW승고，PT、APTT 화 TT 시간연장，FIB승고，차이구유통계학의의（P＜0．05）；이경도아림상갑감조각항지표여건강대조조상비차이무통계학의의（P＞0．05）。결론중도아림상갑감환자PT、APTT급TT시간연장제시응혈공능감퇴，이MPV、PDW급FIB승고제시응혈공능항진，저충변화가능시도치심혈관질병발생적유인。
Objective To study the alteration and the value of platelet parameters and the blood clotting pa-rameters in sub-clinical hypothyroidism (SCH) patients .Methods Levels of FT3 ,FT4 and TSH were detected by E-lectro-Chemiluminescence Immunoassay (ECLIA) in 90 patients with SCH .According to the levels of FT 3 ,FT4 and TSH ,90 patients were divided into three groups including control group (TSH 0 .27 -4 .2 uIU/mL ) ,mild SCH group (TSH 4 .3 -10 .0 uIU/mL ) and severe SCH (TSH 10 .1 -20 .0 uIU/mL ) group .The prothrombin time (PT) ,activated partial thromboplastin time (APTT ) ,thrombin time (TT ) ,fibrinogen (FIB) ,the platelet count (PLT) ,mean platelet volume (MPV) and platelet distribution width (PDW) of each group were detected and com-pared .Results There were no significant differences on PLT among the three group .Compared with the control group ,the levels of MPV ,PDW ,PT ,APTT ,TT and FIB in the severe SCH group were significant higher (P<0 .05) ,and no significant differences on these indicators were noted between the control group and the mild SCH group .Conclusion The disorder of MPV ,PDW ,PT ,APTT ,TT and FIB in the severe SCH patients might lead to the occurrence of cardiovascular diseases .