肾病综合征甲状腺功能的研究

目的　进一步探讨肾病综合征的甲状腺功能。方法　对 48例肾病综合征大量蛋白尿期测定甲状腺功能 (T3、T4 、TSH)、血清白蛋白、2 4小时尿蛋白 ,另 2 0例治疗获缓解后 3个月复查T3、T4 、TSH ,并与正常健康同龄儿作对照 ;结果　肾病综合征组血T3、T4 水平明显低于对照组 (P均 <0 .0 1) ,TSH差异无显著性 (P>0 .0 5 ) ,各种病理类型血清甲状腺激素和 2 4小时尿蛋白差异无显著性 (P均 >0 .0 5 ) ,单纯性肾病与肾炎性肾病血清甲状腺激素水平差异无显著性 (P均 >0 .0 5 ) ,治疗获得缓解后的患儿血清甲状腺激素水平与对照组相比差异无显著性 (P均 >0 .0 5 ) ,血清T3、T4 变化与尿蛋白呈负相关 (r =-0 .48～ -0 .74) ,与血清白蛋白呈正相关 (r =0 .7～ 0 .78) ;结论　肾病综合征大量蛋白尿期存在暂时性甲状腺功能低下 ,与甲状腺激素伴随大量蛋白尿有关 ,监测甲状腺功能对估计病情、判断预后、指导治疗有重要意义。

Thyroid function study in nephrotic syndrome

Objective To investigate the thyroid function in nephrotic syndrome(NS).Methods Thyroid function(T 3、T 4、TSH),hematocyanin,24 hours urinary protein were detected in forty-eight children with NS in state of heavy proteinuria.20 ameliorated cases were observed in coparisos with age-matched healthy children by T 3、T 4、TSH.Results The serum T 3、T 4 level in the group with NS was significant lower than that of compared-group( P <0.01).TSH( P >0.05).Pathological serum thyroxine and 24 hours urinary protein( P >0.05).The same to nephrosis and nephritis with serum thyroxine( P >0.05).Serum T 3、T 4 hsa a negative relevance with urinary protein( r =-0.48～-0.74),and positive relevance with hematocyannin( r =0.7～0.78).Conclusion There are temporary decrease of thyroid function at the heavy proteinuria statc of NS,relate to thyroxine with heavy protienuria.Detecting thyroid function plays an important role in estimate the state,prognosis and guide the treatment of NS.