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目的 观察原发性甲减患者在左旋甲状腺素治疗后血脂、心肌酶谱及体成分的改变。方法原发性甲减患者58例,在诊断初和经左旋甲状腺素治疗2个月时分别测定空腹血清FT3、FT4、sTSH、总胆固醇(TC)、甘油三酯(TG)、门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)及其同工酶CKMB、乳酸脱氢酶(LDH)及其同工酶HBDH,同时测定其体成分,包括体重(W)、体重指数(BMI)、脂肪含量百分比(FAT% )、基础代谢率(BMR)、脂肪含量(FM)、非脂肪量(FFM)以及全身水量(TBW)。结果 治疗前,TC水平与FT3、FT4及sTSH水平显著相关,而TG水平却未表现出与甲状腺功能有相关性。同时,FT4 水平与所有心肌酶均呈负相关,而FT3 和sTSH水平却仅与CK、LDH和HBDH水平呈轻度相关。治疗后,患者甲状腺功能均恢复至正常范围,血清TC水平下降25. 9% (P<0. 01 ),TG则下降11. 6% (P>0. 05 )。血清CK、CKMB、LDH以及HBDH平均下降幅度则分别为54. 5%、10. 8%、12. 3%和8. 5% (均P<0. 05)。治疗前后患者的体成分测定显示,W、FM、BMR、BMI以及FAT%分别下降(1. 7±3. 9 )kg、( 2. 4±3. 5 )kg、( 64. 3±140. 2)kJ、(0. 7±1. 5)kg/m2 和(3. 0±3. 5)% (均P<0. 05),而FFM和TBW则无明显变化。BMI减少的绝对值与FT3、FT4和sTSH的变化幅度均呈显著正相关。与体重的减少相?
Objective To observe the changes of serum lipids, myocardial enzymes and body composition in patients with primary hypothyroidism after levothyroxine treatment. Methods Fifty-eight patients with primary hypothyroidism were enrolled in this study. Fasting serum FT3, FT4, sTSH, total cholesterol (TC), triglyceride (TG), aspartate AST, CK and CKMB, lactate dehydrogenase (LDH) and their isoenzymes HBDH were measured. The body composition, including body weight (W) Fat%, BMR, FF, FFM, and TBW. Results Before treatment, TC levels were significantly correlated with FT3, FT4 and sTSH levels, while TG levels did not show any correlation with thyroid function. At the same time, FT4 levels were negatively correlated with all myocardial enzymes, while FT3 and sTSH levels were only mildly correlated with CK, LDH and HBDH levels. After treatment, thyroid function in patients returned to normal range, serum TC levels decreased 25.9% (P <0.01), TG decreased 11. 6% (P> 0.05). The mean decreases in serum CK, CKMB, LDH, and HBDH were 54.5%, 10.8%, 12.3%, and 8.5%, respectively (all P <0.05). The body composition of patients before and after treatment showed that W, FM, BMR, BMI and FAT% decreased (1. 7 ± 3. 9) kg, (2. 4 ± 3.5) kg, (64.3 ± 140) 2) kJ, (0.7 ± 1.5) kg / m2 and (3.0 ± 3.5)% (all P <0.05), while there was no significant change in FFM and TBW. There was a significant positive correlation between the absolute value of BMI reduction and the change of FT3, FT4 and sTSH. And weight loss phase?