高通量透析对血清甲状腺激素的影响  

THE AFFECT OF HIGH FLUX HEMODIALYSIS ON SERUM THYROID HORMONE

作　　者：范文奎[1] 梁艳影[1] 高爱华[1] 杨红[1] 陈光贤[1] 周少雄[1] 

机构地区：[1]佛山市第二人民医院,广东佛山528000

出　　处：《现代医院》2005年第12期29-31,共3页Modern Hospitals

摘　　要：目的探讨高通量透析对血清甲状腺激素的影响。方法采用双盲随机对照,A组应用高通量透析,B组应用普通透析,分时点检测病人空腹透析前血清总T3、总T4、游离T3、游离T4和血清TSH的水平。进行组内和组间数据对照分析,观察实验期间病人甲状腺激素变化情况。结果 A组病人血清游离T4和总 T4逐渐降低,3月时降至最低(游离T4 8．58±0．97 pmol／L;总T4 5．10±0．57 μg/dl),之后逐渐恢复正常;TSH逐渐升高,3月时最高(3．66±0．07 μIU／ml)并维持,但TSH水平仍正常;游离T3和总T3无明显变化。3月时游离 T4和总T4降低、TSH升高与各时点数据比较有显著差异,P<0．05。B组病人血清甲状腺激素实验期间各时点数据无明显变化,数据分析,P>0．05,无统计学意义。A组与B组数据比较,A组游离T4和总T4仅在3月时下降明显(P<0．05);A组TSH在3月时明显升高(P<0．05)并维持。结论高通量透析可丢失较多游离 T4,总T4因转化增多也降低,但呈一过性,随着血清TSH的增高游离T4和总T4恢复正常。普通透析病人甲状腺激素基本正常,无明显变化。Objective To investigate the effects of high flux hemodialysis on serum thyroid hormone. Methods Randomly dividing into two groups, A group use high flux hemodialysis, B group use low flux maintenance hemodialysis.Before eating breakfast and hemodialysis, we examine the serum thyroid hormone （T3 T4 FT3 FT4 TSH） of the patients on the different point of time. After comparing the data in the same group and with the other group, we investigate the difference of senan thyroid hormone in the studying time. Results FT4 and T4 gradually reduced to the lowest degree （FT4 8.58 ± 0.97 pmol/L; T4 5.10 ± 0.57 μg/dl）on the 3rd month in A group, and then they gradually rise to the normal degree; TSH gradually rise to the highest degree （3.66±0.07 μIU/ml） on the 3rd month, but it is within normal scale; FT3 and T3 had no change. To comparing the data of FT4 T4 TSH on the different times, FT4 and T4 significantly reduced, TSH significantly rise, P 〈 0.05. These data not significantly changed in B group, P 〉 0.05. Comparing A group with B group, FT4 and T4 of A group significantly reduced on the 3rd month, TSH of A group significantly rise and maintain later, P 〈 0.05. Conclusion When the patients was treated with high flux hemodialysis, FT4 and T4 of the patients can reduce in a short time and rise to the normal degree later because of the rising of TSH. The thyroid hormone not significantly change in the low flux hemodialysis patients.

关 键 词：血液透析 高通量透析 甲状腺激素 

分 类 号：R581[医药卫生—内分泌] R459.5[医药卫生—内科学]