低T3综合征对维持性血液透析患者的生存预后影响  

Influence of low triiodothyronine syndrome on the prognosis of maintenance hemodialysis patients

作　　者：黄国海 许少英[1] 李绪城[1] HUANG Guohai;XU Shaoying;LI Xucheng(Department of Blood Purification,Shantou Central Hospital,Shantou 515041,China)

机构地区：[1]汕头市中心医院血液净化中心,广东汕头515041

出　　处：《汕头大学医学院学报》2022年第1期29-32,共4页Journal of Shantou University Medical College

基　　金：汕头市医疗卫生科技计划项目(211116146491392)。

摘　　要：目的:探讨低T3综合征(low triiodothyronine syndrome,LT3S)对维持性血液透析(maintenance hemodialysis,MHD)患者生存预后的影响。方法:选择2018年12月在汕头市中心医院血液净化中心接受MHD治疗的终末期肾病患者作为研究对象。随访并记录患者的临床资料及转归,应用逐步Cox回归分析患者生存预后的影响因素。结果:共纳入283例MHD患者,其中男性167例(59.0%),女性116例(41.0%),年龄(55.9±13.2)岁,合并LT3S 84例(29.7%)。合并LT3S的MHD患者的生存时间[(19.7±0.8)个月]低于非合并LT3S患者的生存时间[(21.8±0.4)个月],差异有统计学意义(χ^(2)=8.38,P=0.004)。逐步Cox回归分析结果显示男性(HR=2.00,95%CI:1.19~3.38,P=0.009)、透析龄>1年(HR=2.62,95%CI:1.47~4.68,P=0.001)、糖尿病(HR=1.75,95%CI:1.07~2.86,P=0.026)、LT3S (HR=1.65,95%CI:1.02~2.65,P=0.041)、血管通路为中心静脉导管(HR=2.45,95%CI:1.35~4.46,P=0.003)、血清白蛋白≤35 g/L(HR=2.91,95%CI:1.70~5.00,P<0.001)为影响患者生存预后的危险因素。结论:LT3S是影响MHD患者生存预后的独立危险因素。Objective:To investigate the effect of low triiodothyronine syndrome (LT3S) on the prognosis of maintenance hemodialysis (MHD) patients.Methods:Patients with end-stage renal disease who received MHD treatment in the blood purification center of Shantou Central Hospital in December 2018 were selected as the research subjects.The clinical data and outcomes of the patients were followed up and recorded,and the influencing factors of prognosis of the patients were analyzed by stepwise Cox regression.Results:A total of 283MHD patients were included,including 167 males (59.0%),116 females (41.0%),age (55.9±13.2) years,and 84(29.7%) patients with LT3S.The survival time of MHD patients with LT3S[(19.7±0.8) months]was lower than that of non-LT3S patients[(21.8±0.4) months],and the difference was statistically significant (χ^(2)=8.38,P=0.004)Stepwise Cox regression analysis showed that male (HR=2.00,95%CI:1.19-3.38,P=0.009),dialysis>1 year (HR=2.62,95%CI:1.47-4.68,P=0.001),diabetes (HR=1.75,95%CI:1.07-2.86,P=0.026),LT3S (HR=1.65,95%CI1.02-2.65,P=0.041),central venous catheter (HR=2.45,95%CI:1.35-4.46,P=0.003),serum albumin≤35 g/L(HR=2.91,95%CI:1.70-5.00,P<0.001) were risk factors affecting the prognosis of patients.Conclusion:LT3S is an independent risk factor affecting the prognosis of MHD patients.

关 键 词：低T3综合征 维持性血液透析 预后 

分 类 号：R692.5[医药卫生—泌尿科学]