未成年肾病综合征患者血清甲状腺激素表达谱变化研究  

A study of the changes in serum thyroid hormone expression spectrum in juvenile patients with nephrotic syndrome

作　　者：胡金喜[1] 朱小丽[2] HU Jinxi;ZHU Xiaoli(Department of Tumor Surgery,Taizhou Hospital of Zhejiang Province,Taizhou317000,China;Department of Clinical Laboratory,Taizhou Hospital of Zhejiang Province,Taizhou317000,China)

机构地区：[1]浙江省台州医院肿瘤外科,浙江台州317000 [2]浙江省台州医院检验科,浙江台州317000

出　　处：《中国现代医生》2020年第18期9-14,共6页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2018KY889);浙江省台州市科技计划(1702KY06、1702KY25)。

摘　　要：目的分析未成年肾病综合征(NS)患者血清甲状腺功能表达谱的变化情况。方法收集2012年7月~2019年7月在我院就诊的小于18周岁NS患者55例临床及实验室信息,其中首次发病患者28例,复发患者27例,以59例健康体检未成年人作为健康对照组。分析NS患者及健康对照者甲状腺功能表达谱的差异,用相关性分析分析甲状腺功能表达与各个指标的相关性。结果首次发病NS患者血清FT3、TT3、TT4、rT3、TGAb、TPO水平显著低于健康对照组,血清TSH水平显著高于健康对照组,差异均有统计学意义(P<0.05);复发NS患者血清FT3、TT3、TT4、TGAb、TPO水平显著低于健康对照组,血清TSH水平显著高于健康对照组,差异均有统计学意义(P<0.05)。首次发病NS患者与复发NS患者各指标之间均无差异(均P>0.05)。首次发病NS患者中TT3与ALB(r=0.744,P<0.001)、PA(r=0.658,P<0.001)呈强正相关,TT3与Scr(r=-0.678,P<0.001)呈强负相关。TT4与ALB(r=0.604,P<0.001)、PA(r=0.646,P<0.001)呈强正相关。复发NS患者中,TT3与APOA1(r=0.648,P<0.001)呈强正相关。结论未成年NS患者存在甲状腺激素水平低下的情况,但首次发病和复发NS患者甲状腺激素水平与血清蛋白及肾功能指标相关性有差异。Objective To investigate the changes in serum thyroid hormone expression spectrum in juvenile patients with nephrotic syndrome(NS).Methods The clinical and laboratory information of fifty-five NS patients younger than 18 years old admitted to our hospital from July 2012 to July 2019 were collected,including twenty-eight patients with first onset and twenty-seven patients with relapse.Fifty-nine healthy juveniles were taken as the healthy control group,and correlation analysis was used to analyze the correlation between a thyroid function expression and various indexes.Results The levels of serum FT3,TT3,TT4,rT3,TGAb and TPO in patients with first onset NS were significantly lower than those in healthy control group,and the levels of serum TSH were significantly higher than those in healthy control group,with statistical significance(P<0.05).The levels of serum FT3,TT3,TT4,TGAb and TPO in patients with relapsed NS were significantly lower than those in healthy control group,and the levels of serum TSH were significantly higher than those in healthy control group,with statistical significance(P<0.05).There was no difference between patients with first onset NS and relapsed NS(all P>0.05).TT3 was strongly positively correlated with ALB(r=0.744,P<0.001),PA(r=0.658,P<0.001)and TT3 was strongly negatively correlated with Scr(r=-0.678,P<0.001)in patients with first onset NS.TT4 was strongly positively correlated with ALB(r=0.604,P<0.001)and PA(r=0.646,P<0.001).In patients with relapsed NS,TT3 was strongly positively correlated with APOA1(r=0.648,P<0.001).Conclusion Low thyroid hormone levels exist in juvenile patients with NS,but the correlation between thyroid hormone levels and serum protein and renal function indexes is different between patients with first onset and relapse NS.

关 键 词：未成年人 肾病综合征 甲状腺激素 表达谱 

分 类 号：R726.9[医药卫生—儿科]