原发性肾病综合征患者甲状腺功能变化与尿蛋白水平及病理类型的关系分析  

Analysis on the relationship among thyroid functions,level of proteinuria and pathologic types in patients with primary nephrotic syndrome

作　　者：董丽华 张茜[1] 叶卫丰[1] DONG Li-hua;ZHANG Qian;YE Wei-feng(Department of Clinical Laboratory,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院检验科,北京100050

出　　处：《临床和实验医学杂志》2018年第6期613-615,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨原发性肾病综合征(PNS)患者甲状腺功能变化与其尿蛋白水平及病理类型的关系。方法回顾性选取2014年1月至2016年1月首都医科大学附属北京友谊医院收治的PNS患者46例作为研究对象(研究组)。其中依据甲状腺激素(TH)水平分为甲状腺功能正常组(23例)与甲状腺功能异常组(23例)。选取同期体检正常者46例作为对照组。对比研究组与对照组患者的TH水平,研究甲状腺功能正常组与异常组患者血清白蛋白、尿微量白蛋白及血脂等水平,以及各指标之间的相关性。结果研究组患者FT3与FT4值明显低于对照组,TSH值明显高于对照组(P<0.05);甲状腺功能正常组患者尿微量白蛋白显著低于甲状腺功能异常组,而血清白蛋白显著高于甲状腺功能异常组(P<0.05);PNS伴随异常TH患者尿微量白蛋白、血脂及血清白蛋白与FT3、FT4、TSH的相关性比较分析,血清白蛋白与FT3、FT4之间呈正相关,尿微量白蛋白与FT4之间呈负相关;THS与尿微量白蛋白之间呈正相关,与血清白蛋白之间呈负相关(P<0.05)。结论 PNS是多种机制关联作用而引起的甲状腺功能异常,低蛋白血症、尿微量白蛋白均可造成功能异常。而对于PNS与肾脏病理的关系还有待于临床进一步研究。Objective To explore the relationship among changes in thyroid functions,level of urinary protein and pathologic types in patients with primary nephrotic syndrome(PNS).Methods The clinical data of 46 patients with primary nephrotic syndrome(PNS)in this hospital during January 2014 to January 2016 were retrospectively reviewed,they were allocated in study group,and they were further divided into normal thyroid function subgroup(n=23 cases)and abnormal thyroid fnction subgroup(n=23 cases),and 46 normal persons in the same period were allocated as control group.Comparative studies were carried out in patients of these two groups.The levels of TH,thyroid functions,serum levels of albumin,level of urinary albumin and blood levels of lipid were examined in order to understand their correlation among each index.Results The blood levels of FT3 and FT4 in study group in comparison with those of control group were significantly decreased,the value of TSH in control group was significantly increased than that of control group;normal thyroid function in patients with microalbuminuria was significantly lower than that of patients with abnormal thyroid function,and serum level of albumin was significantly higher than that of patients with abnormal thyroid function.In patients with abnormal level of TH;PNS patients with microalbuminuria,blood lipid and serum albumin and FT3,FT4,TSH comparative analysis of the correlation between serum albumin and FT3,positive correlation between FT4,there was a negative correlation between microalbuminuria and FT4;there was positive correlation between THS and urinary albumin,negatively correlated with serum albumin;and the difference was statistically significant(P<0.05).Conclusion Primary nephrotic syndrome(PNS)is a variety of mechanism related effects caused by abnormal thyroid function,hypoproteinemia,urinary albumin and inactivation of enzymes can cause abnormal function of the thyroid.The relationship between PNS and renal pathology remains to be further clinically studied.

关 键 词：原发性肾病综合征 甲状腺功能变化 尿蛋白水平 病理关系 

分 类 号：R692[医药卫生—泌尿科学]