近年来,对糖尿病伴高血压及心血管并发症的认识已取得共识并出台了相应的诊治指南,但是对于内分泌代谢系统的另一重要疾病——甲状腺疾病与心血管风险的关系和诊治还了解不多,也未引起足够的重视。在2004年的欧洲甲状腺论坛会上首次以“甲状腺与心血管风险”为专题进行了探讨,因为那个阶段发表的几篇流行病学文章提供了甲状腺功能减退(甲减)症与高胆固醇血症、高血压和糖尿病一样,是心血管疾病的一种危险因素的证据[1];其心血管风险不仅发生在临床甲减症患者,也同样可发生在只有促甲状腺素(TSH)水平异常而长期没有临床症状的亚临床甲减症患者;流行病学和临床研究证实了亚临床甲减症是动脉硬化和心血管疾病进展的相关危险因子;甲减通过影响脂代谢、同型半胱氨酸代谢而导致心血管系统受损;超声心动图研究也提示在临床和亚临床甲减症患者因甲状腺功能异常而使心脏功能受损的依据[2]。近年的研究提示,甲状腺激素在心脏上的分子作用发生在甲减症状出现之前,甲状腺激素作为主要的心血管危险因子,为我们了解甲状腺疾病的多种临床表现提供了证据[3-4]。近年在国际甲状腺会议上举办的“甲状腺与心血管风险(Thyroid and Cardiovascular Risk)”、“甲状腺与心血管代谢监护(The Thyroid and CardioMetabolic Care)”的专题讨论吸引了各国内分泌和心血管医生们的极大关注,甚至提出“当甲状腺讲话时,心脏在听(When the Thyroid Speaks,the Heart Listens)”的名句。2010年9月于法国巴黎召开的第14届国际甲状腺学术大会(14thInternational Thyroid Congress,ITC)特设了相关的专题报告与讨论,进一步提出了在甲状腺与心血管风险方面应关注的问题。
Founded in 2001 by the American company Merck, which published the first edition of the famous MerckManual in 1899, MerckMedicus is one of the comprehensive Internet medical resources. This medical portal provides health care professionals with major medical news, rich and comprehensive research and learning resources, and cutting-edge diagnostic tools. All resources are free, and it is a convenient website for professionals to access medical resources.
The Institute of Allergy and Infectious Diseases (NIAID), a member of the NIH in the United States, was established in 1948. It is mainly engaged in basic and applied research on infectious diseases, immune diseases and allergic diseases. The following information sections are available on the Institute's website.