腹膜透析患者甲状腺功能异常与心脏结构及阳虚、气虚体质的关系  

Relationship of Thyroid Dysfunction,Aardiac Structure,Yang Deficiency Constitution and Qi Deficiency Constitution in Patients on Continuous Ambulatory Peritoneal Dialysis

作　　者：何开英 严晓华[2] 耿振波[1] 黄昉萌[2] 金一顺[2] 陈丽[1] 骆杰伟[2] HE Kaiying;YAN Xiaohua;GENG Zhenbo;HUANG Fangmeng;JIN Yishun;CHEN Li;LUO Jiewei(Department of Traditional Chinese Medicine,Fujian Provincial Hospital,Fujian Province,Fuzhou 350001,China;Provincial Clinical Medical College,Fujian Medical University,Fujian Province,Fuzhou 350001,China)

机构地区：[1]福建省立医院中医科,福建福州350001 [2]福建医科大学省立临床医学院,福建福州350001

出　　处：《光明中医》2020年第4期492-496,共5页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：福建省中医药科研项目计划(No.2017FJZYLC104)。

摘　　要：了解持续性不卧床腹膜透析(CAPD)患者甲状腺功能与心脏结构,及与阳虚、气虚体质的关系。方法收集就诊的CAPD患者178例的甲状腺功能、心脏彩超数据,进行中医体质阳虚、气虚体质转化分的判定。结果甲状腺功能异常者占44.9%,低T3综合征占29.2%;左心室肥厚者占69.1%;气虚质37.64%,阳虚质占23.60%。FT3与室间隔厚度(IVST)、左室舒张末内径(LVEDd)、左室后壁厚度(LVPWT)、左心室质量指数(LVMI)、相对室壁厚度(RWT)负相关(r=-0.353、-0.292、-0.391、-0.455、-0.205,均P<0.01);FT4与左房内径(LAD)、LVEDd、LVPWT、LVMI负相关(r=-0.161、-0.279、-0.164、-0.283,均P<0.05);FT3、FT4与阳虚质、气虚质转化分呈负相关(P<0.05)。甲状腺功能异常组的阳虚、气虚转化分、IVST、LVMI、RWT均较正常组高(P<0.01),而左室肥厚率(89.74%)高于正常组(53.06%)(P<0.01)。Logistic回归分析,以左心室肥厚为因变量,FT3的相对危险度(OR值)为0.493(95%CI:0.338~0.720,P<0.001),阳虚质的OR值为11.503(95%CI:3.778~35.025,P<0.001),气虚质的OR值为11.316(95%CI:4.306~29.740,P<0.001)。结论FT3、阳虚质、气虚质可能是CAPD患者并发左心室肥厚的危险因素。Objective To realize the relationship between thyroid function and cardiac structure in patients on continuous ambulatory peritoneal dialysis(CAPD),and to explore the association of thyroid function with yang deficiency constitution and with qi deficiency constitution in those patients.Methods 178 CAPD patients with their consent and knowledge were selected,and the data of thyroid function and cardiac ultrasound was collected.Their constitution of traditional Chinese medicine and calculate the transformed scores of yang deficiency constitution and qi deficiency constitution was determined.Results Patients had thyroid dysfunction accounted for 44.9% and patients with low T3 syndrome accounted for 29.2%.Patients had left ventricular hypertrophy accounted for 69.1%.There were 37.64% patients with qi deficiency constitution and 23.6% patients with yang deficiency constitution.Free triiodothyronine(FT3)was negatively correlated with interventricular septal thickness(IVST),left ventricular end-diastolic diameter(LVEDd),left ventricular posterior wall thickne(LVPWT),left ventricular mass index(LVMI)and relative wall thickness(RWT),and the correlation coefficients were-0.353,-0.292,-0.391,-0.455 and-0.205 respectively(all P<0.01),free thyroxine(FT4)was negatively correlated with left atrial diarIleter(LAD),LVEDd,LVPWT and LVMI,and the correlation coefficients were-0.161,-0.279,-0.164 and-0.283 respectively(all P<0.05),FT3 was negatively correlated with the transformed scores of yang deficiency constitution and qi deficiency constitution(all P<0.05),so as FT4.The transformed scores of yang deficiency constitution and qi deficiency constitutionthe,so as IVST,LVMI and RWT,were higher in thyroid dysfunction group than those in euthyroidism group.The rate(89.74%)of left ventricular hypertrophy was higher in thyroid dysfunction group than that(53.06%)in euthyroidism group.Multivariate logistic regression analysis whether it is left ventricular hypertrophy had been used as the dependent variable showed that the relative risks o

关 键 词：腹膜透析 甲状腺功能 心脏结构 中医体质 

分 类 号：R692.5[医药卫生—泌尿科学]