目的: 探讨Ⅱ型糖尿病人颈部动脉粥样硬化与亚临床甲状腺功能减退症( Subclinical hypothyroidism，
SCH) 的相关性及SCH 与血脂、纤维蛋白原( Fibrinogen，FIB) 、平均血小板体积( mean platelet volume，MPV) 等因
素的关系。方法: 选择住院Ⅱ型糖尿病病人326 名，其中单纯Ⅱ型糖尿病病人226 例，合并SCH 病人100 例; 比
较两组一般资料的差异，分析血清促甲状腺激素( thyroial strmulating hormone，TSH) 与其他因素之间的相关性。
结果:Ⅱ型糖尿病合并SCH 组的女性、病程、颈部动脉粥样硬化患病率、总胆固醇、LDL、FIB、TSH、MPV、BMI 高于
单纯Ⅱ型糖尿病组，单纯Ⅱ型糖尿病组的HDL、吸烟史病人高于Ⅱ型糖尿病合并SCH 组。TSH、FIB、吸烟史、性
别、年龄是血管病变的危险因素。TSH 与FIB、年龄、病程、总胆固醇、LDL、MPV、BMI 成正相关，与性别、FT4、
HDL、吸烟史成负相关。结论:Ⅱ型糖尿病合并SCH 组的颈部动脉粥样硬化的所占比例高，TSH 是Ⅱ型糖尿病病
人颈部动脉粥样硬化的危险因素，且TSH 可能通过改变血脂、FIB、MPV、BMI 等因素促进Ⅱ型糖尿病血管并发症
的形成。

Objective: To investigate the relationship between carotid atherosclerosis and SCH in
patients with type 2 diabetes mellitus and the relationship between SCH and serum lipid，FIB，MPV and
other factors．Methods: There are 326 hospitalized patients with type 2 diabetes，of which only 226
cases of patients with type 2 diabetes mellitus， type 2 diabetic patients with SCH 100 cases; we should
study the difference between the two groups in the general information，analyz the correlation between
the TSH and other factors．Results: In the SCH group，women，course of type 2 diabetes，carotid atherosclerosis
prevalence rate， total cholesterol，LDL，FIB，TSH，MPV，BMI higher than that of type 2
diabetes mellitus，HDL and smoking history in the type 2 diabetes group was higher than that in group
SCH．TSH，FIB， smoking history，gender and age are the risk factors of vascular disease．Positive correlation
between TSH and FIB，age，duration， total cholesterol，LDL，MPV，BMI，FT4，HDL，sex，and
smoking history are negatively correlated．Conclusion: Carotid atherosclerosis with SCH group the prevalence
of type 2 diabetes is high，TSH is a risk factor for type 2 diabetes patients with carotid atherosclerosis，
and the formation of TSH may through the change of blood lipid，FIB，MPV，BMI and other
factors to promote vascular complications in type 2 diabetes mellitus．

R581．2

 收稿日期: 2017－03－03; 修回日期: 2017－06－02
基金项目: 内蒙古自治区自然科学基金项目( 2013MS11105)
作者简介: 邓英英( 1988－) ，女，内蒙古医科大学2014 级在读硕士研究生。
通讯作者: 邱琳，主任医师，E－mail: nmqiulin@ 163．com 内蒙古医科大学附属医院内分泌科， 010050