肾病综合征与失代偿期肝硬化患者血清甲状腺激素水平的检测及其临床意义

目的： 观察肾病综合征、失代偿期肝硬化患者血清甲状腺激素水平的变化，阐明血清甲状腺激素水平与血清白蛋白水平之间的关系。方法： 采用电化学发光免疫法测定30例肾病综合征、30例失代偿期肝硬化患者和30例正常对照组研究对象空腹血清中的促甲状腺激素（TSH）、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平，分析其血清甲状腺激素水平与血清白蛋白水平之间的相关性。结果：2组患者血清中FT4、FT3水平较正常对照组下降(P<0.01），而TSH水平较正常对照组升高（P<0.01）。肾病综合征组患者血清FT3、FT4水平与血清白蛋白水平呈正相关关系（r₁=0.493，r₂=0.574，P<0.01）；失代偿期肝硬化组患者血清FT3、FT4水平与血清白蛋白水平亦呈正相关关系（r₁= 0.513，r₂=0.607，P<0.01）。2组患者TSH水平与血清白蛋白水平之间无相关性（r₁=－0.232，r₂=
－0.129，P>0.05）。结论： 肾病综合征、失代偿期肝硬化患者常出现血清FT3、FT4水平的降低，随着血清白蛋白水平的好转，血清FT3、FT4的水平升高。

Detection of serum thyroid hormone levels in patients with nephrotic syndrome and decompensated cirrhosis and their clinical significances

Objective To observe the changes of serum thyroid hormone levels in patients with nephrotic syndrome and decompensated cirrhosis and clarify the relationship between thyroid hormone level and serum albumin level.Methods The serum thyrotropic-stimulating hormone(TSH) level,serum free triiodothyronine(FT3) level,and serum free tetraiodothyronine(FT4) level were determined by ECLIA in 30 decompensated cirrhosis patients,as well as in 30 patients with nephrotic syndrome and 30 healthy persons(normal control group).The correlation between serum thyroid hormone levels and serum albumin levels were analyzed.Results The FT4 and FT3 levels in two patients groups were decreased compared with normal control group(P<0.01).The levels of serum FT3 and FT4 were positively correlated with serum albumin levels in nephrotic syndrome group(r1=0.493,r2=0.574,P<0.01);the levels of serum FT3 and FT4 were also positively correlated with serum albumin levels in decompensated cirrhosis group(r1= 0.513,r2=0.607,P<0.01).The levels of serum TSH had no correlation with serum albumin levels in two patients groups(r1=-0.232,r2=-0.129,P>0.05).Conclusion The serum FT3 and FT4 levels in the patients with nephrotic syndrome or decompensated cirrhosis is often decreased,and the levels of serum FT3 and FT4 are increased with the improvement of serum albumin levels.