| Objective: Subclinical hypothyroidism(SCH)that only promote endocrine disease increased thyroid hormone levels,in recent years,its incidence is gradually increasin.Although the data show that the adverse reactions associated clinical results between subclinical hypothyroidism and the heart is not clear,this kind of mechanism such as dyslipidemia,hyperhomocysteinemia and autoimmune reactions and increased risk of cardiovascular disease,effects of coronary atherosclerotic heart disease(Coronary heart,disease,CHD)the occurrence of.A prospective cohort study conducted in 9 countries,including Britain,America and Japan,showed that the risk of coronary heart disease and the risk of coronary heart disease increased with the increase of TSH level.Recent guidelines recommend the use of thyroxine replacement therapy in patients with serum TSH>10mIU/L,but in mild subclinical hypothyroidism patients(serum TSH?10mIU/L),there is no definitive conclusion whether lvothyroxine replacement therapy is needed.The purpose of this experiment is to investigate the effect of left thyroid hormone replacement therapy on cardiovascular factors in patients with subclinical hypothyroidism with serum TSH within 4.2-10.0mIU/L.Methods: a total of 106 patients with subclinical hypothyroidism were examined in Department of Endocrinology,Department of Endocrinology and physical examination center of First Affiliated Hospital of Hebei North University in Zhangjiakou,Hebei province in September 2015-2016 December,and the general data of patients were recorded.It was randomly divided into 2 groups,the experimental group was given oral levothyroxine treatment,the control group is not used,the initial thyroid function,blood lipid(TC,TG,LDL),hypersensitivity C reactive protein hsCRP,color Doppler echocardiography(left ventricular end diastolic diameter LVDd,left ventricular ejection fraction EF),carotid artery intima media thickness IMT in two groups were recorded.A monthly review of thyroid function in the experimental group,within 2-3 months as soon as possible to adjust the thyroid function in the normal range,the thyroid function was reexamined every 3 months after the thyroid function was in the normal range,the control group tested once every 3 months of thyroid function.Two groups of blood lipid and hsCRP were detected once every 3 months.After 12 months of cardiac ultrasound and carotid artery color detection,the correlation index was analyzed and compared.To investigate whether the use of thyroid hormone replacement therapy in subclinical hypothyroidism has an effect on cardiovascular related factors.SPSS19.0 software is used to analyze the data of the selected indexes,and the difference of P<0.05 is significant.Result:1.The blood lipid levels of the experimental group and the control group were compared: the blood lipid level in the experimental group was low and the control group was higher,with statistical significance(P<0.05).2.Compared with the hypersensitive C reaction protein in the experimental group and the control group,the level of hsCRP in the experimental group was lower than that in the control group(P<0.05).3.The subclinical arteriosclerosis and plaque progression of the subclinical hypothyroidism patients in the experimental group was lighter than that in the control group(P<0.05).There was no statistical difference between the experimental group and the control group in the left ventricular end diastolic transverse diameter LVDd and the left ventricular ejection fraction EF.Conclusion: 1.After the treatment of subclinical hypothyroidism in patients with subclinical hypothyroidism,levothyroxine decreased the level of blood lipid,hsCRP and IMT.2.There was no significant change in left ventricular function and structure in the treatment of subclinical hypothyroidism with levothyroxine sodium. |
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