糖尿病肾病血清TSH、FT_(4)、FT_(3)表达及与肾损伤的相关性研究  

Correlations between Serum Expressions of TSH,FT_(4) and FT_(3) with Renal Injury in Patients with Diabetic Nephropathy

作　　者：宋全超 王思宏 刁欣晨 倪孝兵 张卫星 SONG Quan-chao;WANG Si-hong;DIAO Xin-chen;NI Xiao-bing;ZHANG Wei-xing(Department of Endocrinology,People's Hospital of Xuancheng City,Xuancheng,Anhui 242000,China)

机构地区：[1]宣城市人民医院内分泌科,安徽宣城242000

出　　处：《解放军医药杂志》2022年第4期40-42,46,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：安徽省科技攻关项目(1901042231)。

摘　　要：目的分析糖尿病肾病(DN)患者血清促甲状腺激素(TSH)、游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))变化及与肾损伤的相关性。方法将2019年5月—2021年6月收治的单纯糖尿病66例作为糖尿病组,并选取同期就诊的DN 89例作为DN组,另选取同期健康体检者68例作为对照组。比较不同人群血清TSH、FT_(4)、FT_(3)水平;根据尿微量白蛋白排泄率(UAER)将患者肾损伤程度分为轻度组及重度组,并比较2组UAER、尿微量白蛋白(MAlb)水平;采用Pearson相关分析DN患者TSH、FT_(4)、FT_(3)变化与肾损伤的相关性。结果DN组血清TSH水平高于糖尿病组和对照组,血清FT_(4)、FT_(3)水平低于糖尿病组和对照组(P<0.05)。重度组血清TSH、UAER、MAlb水平高于轻度组,FT_(4)、FT_(3)水平低于轻度组(P<0.05,P<0.01)。DN患者TSH与UAER、MAlb呈正相关,FT_(4)、FT_(3)与UAER、MAlb呈负相关(P<0.01)。结论DN患者的TSH与肾损伤呈正相关,FT_(4)、FT_(3)与肾损伤呈负相关,检测三者水平有利于临床对患者肾损伤程度的判断。Objective To analyze correlations between changes in serum expressions of thyroid-stimulating hormone(TSH),free thyroxine(FT_(4))and free triiodothyronine(FT_(3))with renal injury in patients with diabetic nephropathy(DN).Methods A total of 66 patients with simple diabetes mellitus(DM)admitted between May 2019 and June 2021 were selected as DM group,and 89 patients with DN treated at the same period were selected as DN group,while other 68 healthy persons undergoing physical examinations at the same period were selected as control group.Serum expressions of TSH,FT_(4) and FT_(3) in different populations were compared.According to the urinary albumin excretion rate(UAER),the patients were divided into mild subgroup and severe subgroup,and then levels of UAER and urinary microalbumin(MAlb)were compared between the two subgroups.Pearson correlation analysis was used to analyze correlations between changes of TSH,FT_(4) and FT_(3) wit renal injury in patients with DN.Results In DN group,serum TSH level was significantly higher,while serum levels of FT_(4) and FT_(3) were significantly lower than those in DM and control groups(P<0.05).In severe subgroup,serum levels of TSH,UAER and MAlb were significantly higher,while levels of FT_(4) and FT_(3) were significantly lower than those in mild subgroup(P<0.05,P<0.01).TSH was positively correlated with UAER and MAlb,while FT_(4) and FT_(3) were negatively correlated with UAER and MAlb in DN patients(P<0.01).Conclusion TSH is positively correlated with renal injury,while FT_(4) and FT_(3) are negatively correlated with renal injury in DN patients.Detection of levels of the three indexes is conducive to clinical judgment of the degree of renal injury.

关 键 词：糖尿病肾病 促甲状腺素 游离甲状腺素 游离三碘甲腺原氨酸 尿微量白蛋白排泄率 尿微量白蛋白 肾损伤 

分 类 号：R587.24[医药卫生—内分泌]