重度子痫前期合并甲状腺功能减退症患者的甲状腺激素水平与肾功能的相关性

目的探析重度子痫前期合并甲状腺功能减退症患者的甲状腺激素水平与肾功能的相关性。方法选取2012年8月至2014年8月陕西中医药大学第二附属医院128例重度子痫前期患者的临床资料,根据甲状腺激素水平分为亚甲减组(42例),甲减组(54例),单纯子痫前期组(32例),促甲状腺激素(thyroid stimulating hormone,TSH)检测结果均正常。比较3组患者甲状腺激素、肾功能指标;分析甲状腺激素水平与血清尿酸、尿素及肌酐的相关性。结果 3组患者的三碘甲状腺原氨酸(free triiodothyronine,FT3)水平比较差异无统计学意义(P0.05),甲减组游离甲状腺素(free thyroxine,FT4)水平明显低于亚甲减组、单纯子痫前期组(P0.05);单纯子痫前期组TSH与亚甲减组、甲减组比较,明显降低(P0.05)。单纯子痫前期组的各项肾功能检查结果显著低于甲减组(P0.05)。亚甲减组FT3水平与肾功能各项指标呈现负相关状态(P0.05));甲减组患者的FT3水平与血肌酐水平呈负相关,(P0.05);单纯子痫前期组患者的TSH水平与肌酐呈正相关(P0.05)。结论重度子痫前期患者的甲状腺激素的降低程度一定程度地影响了其肾脏代谢的程度,二者有着紧密的相关性。

The correlation of thyroid hormone level and renal function in patients with severe preeclampsia complicated with hypothyroidism

Objective To analyze the correlation of thyroid hormone level and renal function in patients with severe preeclampsia complicated with hypothyroidism. Methods Clinical data of 128 pregnant women with severe preeclampsia treated in The Second Affiliated Hospital of Traditional Chinese Medicine of Shaanxi University from August 2012 to August 2014 was selected. According to the thyroid hormone levels, divided them into subclinical hypothyroidism group (42 cases), and all were diagnosed with subclinical hypothyroidism; hypothyroidism group ( 54 cases ) , merging hypothyroidism; simple preeclampsia group ( 32 cases ) , thyroid stimulating hormone ( TSH ) test results were normal. Compared thyroid hormone, renal function index of three groups;analyzed the correlation of thyroid hormone levels and serum uric acid, urea and creatinine. Results The free triiodothyronine ( FT3 ) of three groups had no obvious difference(P>0. 05), free thyroxine (FT4) of hypothyroidism group was significantly lower than the other two groups(P<0. 05). TSH of simple preeclampsia group decreased obviously than hypothyroidism group(P<0. 05). FT3 level of subclinical hypothyroidism group was negatively related to the kidney function indexes ( P< 0. 05 ); FT3 level of hypothyroidism group was negatively correlated with serum creatinine levels, ( P <0. 05 ); TSH level of simple preeclampsia group was positively related with creatinine (P<0. 05). Conclusion The reduce of thyroid hormone influenced kidney metabolism to a certain extent in patients with severe preeclampsia, both has close correlation.