中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
21期
9480-9484
,共5页
甲状腺功能减退症%血脂异常
甲狀腺功能減退癥%血脂異常
갑상선공능감퇴증%혈지이상
Hypothyroidism%Dyslipidemias
目的：探讨不同程度甲状腺功能减退症和病程对血脂的影响，并观察甲状腺功能减退症患者激素替代治疗后血脂谱的动态变化。方法收集甲状腺功能减退症患者97例，亚临床甲状腺功能减退症32例，中度甲状腺功能减退症28例，重度甲状腺功能减退症37例和31例健康体检者。分别在初诊和激素替代治疗1个月后检测各组血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、脂蛋白（a）[Lp（a）]。通过病史回顾对病程估计的方法确定病程时间。结果不同程度的甲状腺功能减退症对血脂影响不同，重度甲状腺功能减退症组血脂各项均升高，中度甲状腺功能减退症组除TG与HDL-C外均升高，亚甲状腺功能减退症组ApoA与Lp（a）升高。血脂各项与FT3和FT4呈负相关，与TSH呈正相关。甲状腺功能减退症患者激素替代治疗1个月后血脂各项除 Lp（a）外其余基本恢复正常。结论甲状腺功能减退症可引起血脂增高，随甲状腺功能减退症程度加重及病程延长，血脂升高越明显，经激素替代治疗后，甲状腺功能减退症病情好转血脂逐渐恢复，血脂可先于甲状腺功能恢复正常。
目的：探討不同程度甲狀腺功能減退癥和病程對血脂的影響，併觀察甲狀腺功能減退癥患者激素替代治療後血脂譜的動態變化。方法收集甲狀腺功能減退癥患者97例，亞臨床甲狀腺功能減退癥32例，中度甲狀腺功能減退癥28例，重度甲狀腺功能減退癥37例和31例健康體檢者。分彆在初診和激素替代治療1箇月後檢測各組血清遊離三碘甲狀腺原氨痠（FT3）、遊離甲狀腺素（FT4）、促甲狀腺激素（TSH）、總膽固醇（TC）、甘油三酯（TG）、高密度脂蛋白膽固醇（HDL-C）、低密度脂蛋白膽固醇（LDL-C）、載脂蛋白A（ApoA）、載脂蛋白B（ApoB）、脂蛋白（a）[Lp（a）]。通過病史迴顧對病程估計的方法確定病程時間。結果不同程度的甲狀腺功能減退癥對血脂影響不同，重度甲狀腺功能減退癥組血脂各項均升高，中度甲狀腺功能減退癥組除TG與HDL-C外均升高，亞甲狀腺功能減退癥組ApoA與Lp（a）升高。血脂各項與FT3和FT4呈負相關，與TSH呈正相關。甲狀腺功能減退癥患者激素替代治療1箇月後血脂各項除 Lp（a）外其餘基本恢複正常。結論甲狀腺功能減退癥可引起血脂增高，隨甲狀腺功能減退癥程度加重及病程延長，血脂升高越明顯，經激素替代治療後，甲狀腺功能減退癥病情好轉血脂逐漸恢複，血脂可先于甲狀腺功能恢複正常。
목적：탐토불동정도갑상선공능감퇴증화병정대혈지적영향，병관찰갑상선공능감퇴증환자격소체대치료후혈지보적동태변화。방법수집갑상선공능감퇴증환자97례，아림상갑상선공능감퇴증32례，중도갑상선공능감퇴증28례，중도갑상선공능감퇴증37례화31례건강체검자。분별재초진화격소체대치료1개월후검측각조혈청유리삼전갑상선원안산（FT3）、유리갑상선소（FT4）、촉갑상선격소（TSH）、총담고순（TC）、감유삼지（TG）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、재지단백A（ApoA）、재지단백B（ApoB）、지단백（a）[Lp（a）]。통과병사회고대병정고계적방법학정병정시간。결과불동정도적갑상선공능감퇴증대혈지영향불동，중도갑상선공능감퇴증조혈지각항균승고，중도갑상선공능감퇴증조제TG여HDL-C외균승고，아갑상선공능감퇴증조ApoA여Lp（a）승고。혈지각항여FT3화FT4정부상관，여TSH정정상관。갑상선공능감퇴증환자격소체대치료1개월후혈지각항제 Lp（a）외기여기본회복정상。결론갑상선공능감퇴증가인기혈지증고，수갑상선공능감퇴증정도가중급병정연장，혈지승고월명현，경격소체대치료후，갑상선공능감퇴증병정호전혈지축점회복，혈지가선우갑상선공능회복정상。
ObjectiveTo explore the characteristic of serum lipids metabolism under different degrees of hypothyroidism and course, the study observed the dynamic changes in serum lipids metabolism after hormone replacement therapy in patients with hypothyroidism. Methods97 cases of patients with hypothyroidism were collected, 32 patients with subclinical hypothyroidism, 28 patients with moderate hypothyroidism, 37 cases with severe hypothyroidism, and 31 cases of healthy. All patients were examined before and one month after hormone replacement therapy, testing serum free triiodothyronine three (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), total cholesterol(TC), triglyceride(TG), high density lipoprotein(HDL-C), low density lipoprotein (LDL-C), apolipoprotein A(ApoA), apolipoprotein B(ApoB) and lipoprotein (a)Lp(a). Results Serum lipids of the severe hypothyroidism group were higher than the control group. TC, LDL-C, ApoA, ApoB and Lp(a) of the moderate hypothyroidism group were higher than the control group. ApoA and Lp(a) of the moderate hypothyroidism group were higher than the control group. The serum lipids were negatively related to FT3 and FT4, and TSH was positively correlated. Different degrees of hypothyroidism had different effects on serum lipids. The more increase course of hypothyroidism, the more obvious increase in the serum lipids level. Hormone replacement therapy in patients with hypothyroidism, the serum lipids returned to be normal after one month except for Lp(a).ConclusionHypothyroidism can increase serum lipids. The more increase degree and course of hypothyroidism, the more obvious increase in serum lipids level. With the hormone replacement therapy, the serum lipids resumed with hypothyroidism condition improved gradually, serum lipids returned to be normal before the thyroid function.
