肾病综合征患者血清甲状腺激素水平临床观察

目的：观察肾病综合征（NS）患者继发性甲状腺激素水平下降的发生率，并探讨其发病机制。方法：分别用全自动免疫分析仪和全自动生化分析仪检测52例中、重度水肿的NS患者治疗前后及22例原发性甲状腺功能减退症患者、18例健康者的血清FT3，FT4、促甲状腺激素（TSH）、总蛋白、白蛋白及尿总蛋白、白蛋白水平，并分析其血清甲状腺激素与血、尿蛋白间的相关性。结果：52例NS患者中41例甲状腺激素水平较正常值有不同程度下降，其中FT3为（1．72±0．59）pg／mL，FT4为（8．63±1．92）pg／mL，TSH（7．32±3．05）μIU／mL。NS组患者治疗前血清FT3与血清白蛋白水平呈正相关（r=0．387，t=2．523，P〈0．05），FT4与血清白蛋白水平呈正相关（r=0．359，t=2．369，P〈0．05），与尿蛋白（尿总蛋白及尿白蛋白）间无相关性：TSH与血清白蛋白及尿蛋白间无相关性。结论：中、重度水肿的NS患者易出现继发性甲状腺激素水平下降，甲状腺激素改变水平与血清白蛋白水平相关。

Serum thyroid hormone levels in patients with nephrotic syndrome

Objective To observe the incidence of lowering of thyroid hormone levels in patients with nephrotic syndrome. Methods Serum free triiodothyronine （FT3）,serum free tetraiodothyronine （FT4）, serum thyrotropic-stimulating hormone （TSH） were determined by automatic immunology analyzer and serum protein, serum albumin, urinary protein, urinary albumin were assayed by automatic biochemistry analyzer in 52 nephrotic syndrome patients with moderate to severe edema before and after treatment, as well as in 22 patients with primary hypothyroidism and 18 healthy persons. The correlation between serum thyroid hormone levels and levels of serum albumin and urinary protein were analyzed. Results Serum thyroid hormone levels decreased in 41 of 52 nephrotic syndrome patients： FT3 （1.72±0.59） pg/mL, FT4 （8.63±1.92） pg/mL,TSH （7.32±3.05） μlU/mL. Levels of serum FT3 and FT4 were positively correlated with serum albumin （r=0.387,t=2.523,P〈0.05; r=0.359,t=2.369,P〈0.05, respectively）. No correlation was found between serum thyroid hormone levels and urinary protein.Levels of serum TSH had no correlation with serum albumin and urinary protein. Conclusions The incidence of lowering of thyroid hormone levels is high in nephrotic syndrome patients with moderate to severe edema, and correlation is found between serum thyroid hormone levels and serum albumin level.