摘要
目的通过观察糖尿病肾病患者不同肾功能状态下合并甲状腺功能低下状况，检测透析前后甲状腺功能指标的变化，探讨糖尿病肾病患者甲状腺功能异常情况与肾功能的关系以及透析对甲状腺功能指标的影响，以便寻求更好的糖尿病肾病合并甲状腺功能低下的治疗方法。方法将2008年1月至2010年12月我科收治的125例糖尿病肾病合并肾功能异常患者，用化学发光免疫法检测其甲状腺功能指标游离三碘甲状腺原氨酸（FT3）、反游离甲状腺素（FrT4）、促甲状腺素（TSH3）；同时检测肾功能指标血清肌酐（SCr）、尿素氮（BUN）。将其中糖尿病肾病尿毒症期并进行透析替代治疗的患者透析前后甲状腺功能进行重复检测，对透析前后指标进行统计学分析。结果糖尿病肾病患者的SCr、BUN与FT3、FrT4呈负相关（r值分别为-0．65、-0．46，-0．76、-0．56，P均〈0．05）；与TSH3无关（P〉0．05）。糖尿病肾病尿毒症期并进行透析替代治疗的患者透析前后甲状腺功能差异不具有统计学意义。结论糖尿病肾病且肾功能不全患者合并甲状腺功能低下者，其血SCr、BUN与FT3、FrT4呈负相关，而与TSH3无关。透析治疗对于糖尿病肾病合并甲状腺功能异常无治疗意义。
Objective To investigate the relationship between hypothyroidism condition and renal function in diabetic nephropathy （DN） patients via measuring the hypothyroidism status of patients at different renal function stages of DN. Meanwhile, the influence of hemadialysis on thyroid function was also evaluated to pursue better treatment measures for the patients with diabetic nephropathy complicated with hypothyroidism. Observe the influence of hemadialysis in values of thyroid function, and discuss the better therapy of diabetic nephropathy with hypothyroidism. Methods FT3, FrT4,TSH3 were tested by chemiluminescence immunoassay in 125 cases of DN for January 2008 to December 2010, and SCr, BUN were tested at the same time. Then investagated the changes of thyroid function items of DN with uremia patients after hemadialysis. Analyze the data statistically. Results SCr, BUN of DN group were negatively co-related to FT3, FrT4 （ r = - 0. 65, - 0.46, - 0. 76, - 0. 56, P 〈 0.05 ） ; But not co-related to TSH3 （ P 〉 0. 05 ）. The changes of thyroid function items, namely FT3 ,FrT4,TSH3 of DN with uremia patients after hemadialysis was not statistically significant. Conclusion SCr, BUN were negatively correlated to FT3, FrT4, but there was no relation between SCr, BUN and TSH3. Hemadialysis therapy is not beneficial for the hypothyroidism in DN patients.
出处
《中国综合临床》
2011年第12期1292-1294,共3页
Clinical Medicine of China
关键词
糖尿病肾病
甲状腺功能低下
肾功能
透析
Diabetic nephropathy
Hypothyroidism
Renal function
Hemadialysis
