摘要
目的观察慢性肾脏病(CKD)患儿血清甲状腺激素水平变化及其临床意义。方法对78例CKD患儿进行分期(入院治疗前,患儿达到完全缓解后,住院治疗8周确定患儿未缓解时口服小剂量L-甲状腺素片4～6周),于清晨采取其空腹静脉血2～3mL,血标本均采用放射免疫分析法检测其总甲状腺素(T4)、三碘甲状腺原氨酸(T3)、促甲状腺激素(TSH)等指标,观察其变化。采用SPSS11.0软件进行统计学分析。结果CKD患儿治疗前T3明显低于健康对照组(P<0.01),经治疗达到完全缓解时,其T3水平与治疗前及未缓解前比较,均明显升高(Pa<0.01);病情未缓解组T3明显低于健康对照组及缓解组(Pa<0.01),且出现T4下降,明显低于健康对照组及缓解组(Pa<0.01);各组TSH无明显改变(Pa>0.05);治疗无缓解患儿加用小剂量L-甲状腺素片后,T3、T4逐渐升高,与治疗前比较有显著性差异(Pa<0.05),并有部分患儿病情缓解。结论动态检测甲状腺激素水平可作为观察CKD患儿病情、判断疗效及评估预后的有效指标之一。
Objective To investigate the clinical significance and changes of plasma thyroid hormone in patients with chronic kidney diseases （CKD）. Methods Plasma thyroxine （ T4, T3 ） and thyrotropie stimulating hormone（ TSH ） concentration were measured in 78 patients with CKD（ including before treatment, catabatic patients after treatment,uncatabatic patients after treatment for 8 days,then added small dose of L - thyroid hormone for 4 - 6 weeks） by radioimmunoassay. Results Plasma T3 in patients with CKD before administration were markedly lower than that of control group （P 〈 0.01 ）. But T3 level in patients of CKD increased markedly after treatment till complete remission, compared with that before treatment or remission （ P 〈 0.01 ）. The levels of T3, T4 in patients of uncatabatic state of illness were obviously lower than that of control group and the group of catabatic state of illness（P 〈0.01 ） ,but no change of TSH （P 〉0.05 ）. T3 ,T4 gradually rose in the uncabitatic patients after administration with small dose L - thyroid hormone, there were significance compared with that before administration of it （Pa 〈 0.05 ）. Remission occurred in part of patients. Conclusions Dynamic measurement of plasma thyroid hormone in CKD patients might be as an effective indicator for observing state of illness, estimating effect of treatment and evaluating prognosis. If the patients, whose illness remains uncatabatie,receive the treatment with thyroid hormone, the prognosis of CKD may be improved.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第17期1349-1350,共2页
Journal of Applied Clinical Pediatrics
