中国血液净化

中国血液净化

• 临床研究 • 上一篇    下一篇

终末期肾脏病患者甲状腺功能的变化

赵璐杰    李超林   

  1. 烟台毓璜顶医院血液净化中心
  • 收稿日期:2012-01-09 出版日期:2012-08-12 发布日期:2012-12-24
  • 通讯作者: 赵璐杰

Changes of thyroid function in patients with end stage renal disease

ZHAO Lu-jie, LI Chao-lin.   

  • Received:2012-01-09 Online:2012-08-12 Published:2012-12-24

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摘要： 【摘要】目的 探讨终末期肾脏病患者的甲状腺功能变化。 方法 选取2009～2011年烟台市毓璜顶医院住院治疗的慢性肾衰竭患者78例，终末期肾脏病患者非透析组42 例；血液透析组36例，用电化学发光法分别检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、超敏促甲状腺激素(uTSH)水平，在血液透析组中有12例患者血液透析前后测定其血清甲状腺激素；随机选30例同期健康体检者的血清甲状腺功能作为对照。 结果 ① 终末期肾脏病患者非透析、血液透析组血清FT3、 FT4显著低于正常对照（F=3.27和4.31，P＜0.05），uTSH 高于正常对照，差异有统计学意义(F=7.56，P＜0.01)，终末期肾脏病患者非透析组与血液透析组之间甲状腺激素各项指标变化差异无统计学意义(P＞0.05)；② 血液透析组中12例患者血液透析前后甲状腺激素各项指标差异无统计学意义(P＞0.05)；③ 终末期肾脏病患者非透析组、血液透析组甲状腺功能减退明显高于对照组(P＜0.01)，而甲状腺功能亢进与对照组差异无统计学意义(P＞0.05)。结论 终末期肾病患者常伴有甲状腺功能异常，主要表现为甲状腺功能减退，普通血液透析不能改变终末期肾脏病患者甲状腺激素水平。

关键词: 终末期肾病, 甲状腺功能, 血液透析

Abstract: 【Abstract】 Objective To investigate the changes of thyroid function in patients with end stage renal disease (ESRD) with or without dialysis. Methods Serum free-T3 (FT3), free-T4 (FT4) and thyrotropin (uTSH) concentrations were measured by electrochemiluminescence. These levels were compared in ESRD patients not on dialysis (n=42), those on hemodialysis (n=36), those on hemodialysis before and after hemodialysis sessions (n=12), and normal control subjects (n=30). Results (a) Compared with normal controls, serum levels of FT3 and FT4 were significantly lower (P＜0.05), and uTSH content was significantly higher (P＜0.01) in patients with ESRD. However, the differences of serum FT3 and FT4 levels were insignificant between ESRD patients on dialysis group and not on dialysis group (P＞0.05). (b) Serum FT3 and FT4 changed insignificantly in hemodialysis patients before and after hemodialysis sessions (P＞0.05). (c) The prevalence of hypothyroidism was higher in ESRD patients than in normal controls (P＜0.01), but the prevalence of hyperthyroidism was similar in ESRD patients and normal controls (P＞0.05).  Conclusion Thyroid dysfunction with hypothyroidism is frequently found in ESRD patients. Dialysis can not change this abnormality.

Key words: End stage renal disease, Thyroid function, Hemodialysis