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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。治疗后,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。
Objective To observe the changes of lipids and myocardial enzymes in patients with primary hypothyroidism after levothyroxine treatment. Methods Thirty patients with primary hypothyroidism were enrolled in this study. Fasting serum FT3, FT4, TSH, total cholesterol (TC), triglyceride (TG), low density lipoprotein LDL-C), aspartate aminotransferase (AST), creatine kinase (CK), lactate deaminase (LDH) and its isoenzyme HBDH. Results Before treatment, TC and LDL-C levels were significantly correlated with FT3, FT4 and TSH levels, whereas TG levels had no correlation with thyroid function. The levels of myocardial enzymes were significantly correlated with thyroid function. After treatment, serum TC level decreased by 44.6% (P <0.01), LDL-C decreased by 39.3% (P <0.01), TG decreased by 27.1% (P> 0.05). The average decrease of serum CK, AST, LDH and HBDH were 79.3%, 51.0%, 37.9% and 38.2% respectively (all P <0.01). Conclusion Primary hypothyroidism patients with levothyroxine treatment can significantly reduce cholesterol, triglyceride, low density lipoprotein and myocardial enzyme levels.