瑞舒伐他汀联合甲状腺激素替代治疗对老年甲状腺机能减退症患者血脂、脂质过氧化和颈动脉硬化的影响

摘要

Objective To investigate the effect of rosuvastatain combined with thyroid hormones replacement therapy on carotid artery intima-media thickness(IMT) , plasma levels of lipids and lipid peroxidation in old patients with hypothyroidism. Methods 67 old patients with hypothyroidism were collected and divided into control group( n = 34) and experimental group(n = 33). Patients in the control group were given thyroid hormones replacement therapy. Patients in the experimental group were given rosuvastatain on the basic treatment of control group. The total treatment course last 6 months. The carotid artery IMT, levels of plasma lipids,levels of ox-LDL and LPO were compared before and after treatment. Results There were no significant difference in IMT,the levels of lipid ox-LDL and LPO between control group and experimental group before treatment. The levels of TG and TC decreased significantly in experimental group compared with control group after treatment(P<0. 05). The levels of plasma ox-LDL, LPO and IMT of carotid artery were decreased obviously in two groups after treatment(P<0. 05). The levels of ox-LDL and IMT decreased significantly in experimental group compared with control group(P<0. 05). Conclusion Combination of rosuvastatain and thyroid hormones replacement therapy could decrease the levels of lipid peroxidation and plasma lipids,and delay the progression of arteriosclerosis in patients with hypothyroidism.%目的 研究瑞舒伐他汀联合甲状腺激素替代治疗对老年甲状腺机能减退症(简称甲减)患者血脂、脂质过氧化和颈动脉内膜-中层厚度(IMT)的影响.方法 收集合并颈动脉硬化的老年甲减患者67例,将其随机分为2组,其中对照组34例,给予甲状腺激素替代治疗;试验组33例,在对照组治疗的基础上给予瑞舒伐他汀治疗,2组总疗程均为6月.比较治疗前后2组患者血脂、血浆ox-LDL和LPO水平和颈动脉IMT的变化.结果 治疗前,2组患者血脂、ox-LDL、LPO和颈动脉IMT差异无统计学意义(P>0.05);治疗后,试验组TG、TC水平显著下降,与治疗前及对照组比较,差异有统计学意义(P<0.05);两组患者血浆ox-LDL、LPO和颈动脉IMT均较治疗前显著降低(P<0.05),而试验组颈动脉IMT和ox-LDL水平较对照组的降低更具显著性(P<0.05).结论 瑞舒伐他汀联合甲状腺激素替代治疗老年甲减可有效调脂、减轻脂质过氧化,延缓动脉粥样硬化的发展.