儿童原发性肾病综合征的甲状腺功能变化

目的 探讨原发性肾病综合征（NS）患儿发作期和缓解期的甲状腺功能变化.方法 回顾性分析15例原发性NS患儿在发作期和缓解期的尿蛋白定量及血清白蛋白、总胆固醇、甲状腺激素水平总三碘甲腺原氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）及促甲状腺素（TSH）].结果 NS患儿发作期和缓解期尿蛋白定量及血清白蛋白、总胆固醇比较差异有统计学意义（P＜0.05）.发作期NS患儿TT3、TT4、FT3、FT4水平均显著低于缓解期（0.6±0.3）μg/L比（1.3±0.3）μg/L、（40.0±23.0） μg/L比（68.0± 15.0） μg/L、（1.6±0.3） pmol/L比（3.3±0.3）pmol/L、（8.6±2.5） pmol/L比（12.2±2.0）pmol/L],TSH水平显著高于缓解期（5.6±2.1） mU/L比（2.5±1.1） mU/L],差异有统计学意义（P＜0.05）.结论 原发性NS患儿发作期存在暂时性甲状腺功能低下,与大量蛋白尿导致甲状腺激素从尿中丢失有关.监测甲状腺功能对估计病情和指导治疗有重要意义.

Thyroid function changes in children with primary nephrotic syndrome

Objective To explore the thyroid function changes of episodes period and remissions period in children with primary nephrotic syndrome （NS）.Methods The urinary protein quantitation and serum albumin,total cholesterol,thyroid hormone level total triiodothyronine （TT3）,total thyroxine （TT4）,free triiodothyronine （FT3）,free thyroxine （FT4） and thyroid stimulating hormone （TSH）] of episodes period and remissions period in 15 children with primary NS were retrospectively analyzed.Results There were statistical differences in urinary protein quantitation and serum albumin,total cholesterol in children with NS between episodes period and remissions period （P 〈 0.05）.The TT3,TT4,FT3,FT4 in episodes period were significantly lower than those in remissions period （0.6 ± 0.3） μ g/L vs.（1.3 ± 0.3） μ g/L,（40.0 ± 23.0）μ g/L vs.（68.0 ± 15.0） μ g/L,（1.6 ± 0.3） pmol/L vs.（3.3 ± 0.3） pmol/L,（8.6 ± 2.5） pmol/L vs.（12.2 ± 2.0） pmol/L],TSH was significantly higher than that in remissions period （5.6 ± 2.1） mU/L vs.（2.5 ± 1.1） mU/L],there were statistical differences （P 〈 0.05）.Conclusions Thyroid function of episodes period in children with primary NS is decreased temporarily,associated with heavy proteinuria leads to thyroid hormone missing from urine.Detecting thyroid function plays an important role in estimating the state and guiding the treatment of primary NS.