持续性非卧床腹膜透析患者肝肾阴虚证与低T3综合征的关系

目的:探讨持续性非卧床腹膜透析(CAPD)患者本虚证候与血清游离三碘甲腺原氨酸(FT3)水平的关系。方法:对2009年3月～4月在北京大学第三医院肾内科接受持续性非卧床腹膜透析的患者进行横断面调查。检测血清甲状腺激素(TT3、TT4、FT3、FT4、TSH)水平及生化项目。采用均数比较及多因素分析等统计学方法探讨肝肾阴虚证与FT3水平的关系。结果:共纳入正常促甲状腺素(TSH)的CAPD患者89例,分为肝肾阴虚证组(19例),非阴虚证组(70例),结果显示肝肾阴虚证组血清TT3、TT4与FT3均明显低于非阴虚证组[TT3(0.96±0.23)μg/mlvs(1.13±0.22)μg/ml,P<0.01;TT4(7.59±1.69)μg/mlvs(8.65±1.55)μg/ml,P<0.01;FT3(2.35±0.35)pg/mlvs(2.57±0.33)pg/ml,P<0.01)];多因素分析结果示在矫正性别、年龄、糖尿病、透析龄等因素后,肝肾阴虚、血清白蛋白、C反应蛋白与残肾Kt/V是FT3的独立影响因素(R2=0.396,P<0.01)。结论:本研究表明肝肾阴虚证可能与CAPD患者低T3综合征的发生密切相关。

Association Between Gan-Shen Yin-Deficiency Type and Low Triiodothyronine Syndrome in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Objective:To explore the association between the Root syndromes and serum Triiodothyronine(T3) in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods:A cross-sectional study was performed in CAPD patients treated in the division of nephrology,Peking University Third Hospital between March and April 2009.Thyroid hormones profiles including triiodothronine(T3,total and free),throxine(T4,total and free),and thyrotropin(TSH),blood biochemistry were measured.Comparisons between groups and multivariate analysis were used to explore the relationship between Gan-Shen Yin-deficiency type and free serum triiodothyronine.Results:89 patients with euthyroid were included in the present study.Patients were divided into two groups,Gan-Shen Yin-deficiency type(n=19) and non-Gan-Shen Yin-deficiency type(n=70).Patients defined as Gan-Shen Yin-deficiency type had significantly lower levels of serum TT3,TT4 and FT3 than their counterparts ml vs(8.65±1.55) μg/ml,P<0.01;FT3(2.35±0.35) pg/ml vs(2.57±0.33) pg/ml,P<0.01],respectively.Multivariate analysis further showed that Gan-Shen Yin-deficiency,serum albumin,C-reactive protein and residual renal Kt/V were independent risk factors affecting the levels of serum FT3 after adjusting for age,sex,dialysis vintage and diabetic status(R2=0.396,P<0.01).Conclusion:Our study shows that there may be a close association between Gan-Shen Yin-deficiency type and low T3 syndrome in CAPD patients.