慢性肾脏病患者的甲状腺功能和血脂水平分析  

Analysis of thyroid function and lipid levels in patients with chronic kidney disease

作　　者：韦莉 缪淑贤 徐华国 张伟 WEI Li;MIAO Shuxian;XU Huaguo;ZHANG Wei(Department of Laboratory Medicine,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院检验学部,江苏南京210029

出　　处：《国际检验医学杂志》2022年第4期441-444,共4页International Journal of Laboratory Medicine

基　　金：江苏省实验诊断学重点实验室基金项目(ZDXKB2016005)。

摘　　要：目的探讨慢性肾脏病(CKD)患者的甲状腺功能和血脂状况。方法收集2017年1—10月该院肾脏科CKD患者412例,分别检测血清尿素(Urea)、肌酐(Cr)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺素(TSH)水平,计算估算肾小球滤过率(eGFR)。比较CKD各期患者的甲状腺激素和血脂水平,对甲状腺激素和血脂水平与肾功能指标Cr和eGFR进行相关性分析,并对CKD各期患者的甲状腺功能和血脂疾病进行比较。结果CKD各期患者间Urea、Cr、TC、LDL-C、HDL-C、FT4和TSH差异有统计学意义(P<0.05),FT3差异无统计学意义(P>0.05)。FT4、HDL-C水平与Cr呈负相关(r=-0.312、-0.207,P<0.05),与eGFR呈正相关(r=0.282、0.160,P<0.05);TSH、TC、LDL-C水平与Cr呈正相关(r=0.143、0.205、0.218,P<0.05),与eGFR呈负相关(r=-0.123、-0.183、-0.193,P<0.05)。CKD患者中高胆固醇血症、高三酰甘油血症、低高密度脂蛋白胆固醇血症、高低密度脂蛋白胆固醇血症发生率分别为18.93%、21.12%、58.25%、12.14%。有20.88%的CKD患者存在甲状腺功能紊乱,最常见的是亚临床甲状腺功能减退(14.08%),其次是临床甲状腺功能减退(3.64%)和亚临床甲状腺功能亢进(3.16%)。结论甲状腺功能紊乱和血脂异常是CKD患者常见的表现,动态监测CKD患者的甲状腺功能和血脂水平可为早期诊断并治疗甲状腺和血脂疾病提供理论依据。Objective To investigate the thyroid function and blood lipid status in the patients with chronic kidney disease(CKD).Methods A total of 412 patients with CKD admitted to the nephrology department of this hospital from January 2017 to October 2017 were collected.The levels of serum Urea,creatinine(Cr),total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),free triiodothyronine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH)were measured.The estimated glomerular filtration rate(eGFR)was calculated.The thyroid hormones and blood lipids were compared among different stages of CKD.The correlation between the thyroid hormones,and blood lipids levels with the renal indicators Cr and eGFR were analyzed,and the thyroid function and disease of blood lipids were compared among the patients with different stages of CKD.Results The differences in Urea,Cr,TC,LDL-C,HDL-C,FT4 and TSH had statistical significance among the patients with different stages of CKD(P<0.05),while the FT3 difference was not statistically significant(P>0.05).The levels of FT4 and HDL-C were negatively correlated with Cr(r=-0.312,-0.207,P<0.05),but positively correlated with eGFR(r=0.282,0.160,P<0.05);the levels of TSH,TC and LDL-C were positively correlated with Cr(r=0.143,0.205,0.218,P<0.05),but negatively correlated with eGFR(r=-0.123,-0.183,-0.193,P<0.05).The incidence rates of hypercholesterolemia,hypertriglyceridemia,low HDL-C and high LDL-C were 18.93%,21.12%,58.25%and 12.14%,respectively.The thyroid dysfunction existed in 20.88%of CKD patients,subclinical hypothyroidism(14.08%)was most common,followed by clinical hypothyroidism(3.64%)and subclinical hyperthyroidism(3.16%).Conclusion The thyroid dysfunction and dyslipidemia are common manifestations in CKD patients.Dynamic monitoring of thyroid function and blood lipid levels in CKD patients may provides a theoretical basis for early diagnosis and treatment of thyroid and blood lipids diseases.

关 键 词：慢性肾脏病 血脂异常 亚临床甲状腺功能减退 甲状腺功能紊乱 

分 类 号：R692[医药卫生—泌尿科学]