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1、授予单位代码10089学号或申请号13252H妗(E搿大交HebeiMedicalUniversity硕士学位论文在职科学学位甲状腺功能亢进患者甲状腺功能与肺动脉压力相关性研究学位申请人：刘丹导师：王瑞英教授专业：内科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、原始数据、申报的专利等知识产
2、权均归河北医科大学所有。否则,承担相应法律责任。丨研究生签名：1导师签章二级学院领导盖章：I年jr月飞丄曰河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：导师签章：2/oaT年r^日目录中文摘要·············································································1英文摘要············
3、·································································4研究论文甲状腺功能亢进患者甲状腺功能与肺动脉压力相关性研究前言·············································································9对象与方法····································································11结果································
4、·············································13附表·············································································15讨论·············································································17结论·········································································
5、····20参考文献·······································································20综述甲状腺疾病与肺动脉高压的关系······································24致谢···················································································33个人简历······················································
6、·······················34中 文 摘 要甲状腺功能亢进患者甲状腺功能与肺动脉压力相关性研究摘要目的：甲状腺功能亢进症(Hyperthyroidism,简称甲亢),是内分泌专业最常见的疾病之一,在普通人群中的患病率达到0.5%,也有报道可达1%,男女患病比例为1:4-6,在女性人群中患病率在2%左右。临床中,依据甲亢发生的病因不同,分为：弥漫性毒性甲状腺肿、结节性毒性甲状腺肿、甲状腺自主高功能腺瘤和碘甲亢。在众多病因导致的甲亢中,毒性弥漫性甲状腺肿（Gravesdisease,GD）的比例可达85%左右,因GD患病率为最高,发病情况也最为普
7、遍,所以一般意义上的甲亢都指的是GD。近些年来,较多报道都提示了甲状腺功能亢进症与肺动脉高压（Pulmonaryhypertension）可以同时合并出现,这种现象,也在内分泌专业医生中,逐渐得到重视。第3次世界卫生组织肺动脉高压专家组会议,在关于肺动脉高压新诊断分类标准中,针对特发性肺动脉高压的病因,明确纳入了甲状腺疾病作为其中一个病因,且称其为“不可忽视的”危险因素。报道中,尤其提到以甲亢合并肺动脉高压的现象最为多见,其病因尚未能完全阐述明确,可能与甲亢导致的高心输出量、高动力循环状态密切相关,也有人推断,甲状腺疾病的发生往往与自身免疫有密切的相关性,甲亢合
8、并肺动脉高压,也可能与自
