特发性肾病综合征患儿血清游离甲状腺激素检测的临床意义

探索特发性肾病综合症（ＩＮＳ）患儿血清游离甲状腺激素（ＴＨ）、甲状腺激素结合球蛋白（ＴＢＧ）的变化情况及其变化的机理和临床意义。对１６例ＩＮＳ患儿及１５例正常儿童对照，用放免法测Ｔ３、Ｔ４、ＦＴ３、ＦＴ４，化学发光酶免疫分析法测ＴＳＨ、ＴＢＧ，放射配基单点饱和饱和结合分析法测糖皮质激素受体（ＧＣＲ）。结果：①ＩＮＳ患儿Ｔ３、Ｔ４、ＦＴ３、ＦＴ４均低于对照组，ＴＳＨ升高，差异非常显著。②ＴＢＧ降低，ＴＢＧ与ＴＨ呈正相关。③ＩＮＳ患儿ＧＣＲ升高，ＴＨ与ＧＣＲ未见相关性。提示对糖皮质激素（ＧＣ）治疗敏感的ＩＮＳ患儿，虽然其ＴＨ是降低的，但其ＧＣＲ是升高的。

Detection of serum free thyroid hormones and its clinical significance in children with idiopathic nephrotic syndrome

To explore the clinical significance for the determination of serum free thyroid hormones (TH) in children with idiopathic nephrotic syndrome (INS),serum thyroid stimulation hormones (TSH) and thyroid binding globulin (TBG) by chemiluminescent enzyme-immunoassay, glucocorticoid receptor (GCR) by radioligand binding method, and T3, T4, FT3 and FT4 by radioimmunoassay were determined in 16 children with INS and 15 normal children, respectively. The results showed that: (1) serum T3, T4, FT3 and FT4 decreased and TSH increased significantly in INS patients comparing to the control children. (2) Serum TBG that was correlated with TH positively decreased in INS children markedly. (3) Serum GCR that was not correlated with TH increased in INS patients obviously. It is concluded that serum GCR is increase in the INS patients who are sensitive to GC administration although their TH is decrease.