T2DM合并SCH患者肾功能变化研究  

Changes of renal function in patients with T2DM complicated with SCH

作　　者：白威峰[1] 张珍[2] BAI Weifeng;ZHANG Zhen(Department of Nuclear Medicine,Bengbu First People's Hospital,Bengbu,Anhui,China,233000;Department of Clinical Laboratory,Bengbu First People's Hospital,Bengbu,Anhui,China,233000)

机构地区：[1]安徽省蚌埠市第一人民医院核医学科,安徽蚌埠233000 [2]安徽省蚌埠市第一人民医院检验科,安徽蚌埠233000

出　　处：《分子诊断与治疗杂志》2023年第1期26-29,共4页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省自然科学基金项目(2020015QH101)。

摘　　要：目的 探讨单纯2型糖尿病(T2DM)及T2DM合并亚临床甲状腺功能减退症(SCH)患者肾功能指标之间的差异。方法 选取2020年1月至2022年7月安徽省蚌埠市第一人民医院收治的88例T2DM合并SCH患者作为观察组,将同期128例T2DM患者(甲状腺功能正常)作为对照组。比较两组病人的促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)及甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、血β2微球蛋白(β2-Mg)、尿β2微球蛋白(β2-Mg)、尿微量白蛋白(mALb)、尿素氮(BUN)、胱抑素C(Cys C)水平。结果 与对照组相比,观察组TSH、TGAb、TPOAb水平明显升高,FT4水平明显降低,差异有统计学意义(Z=-12.479、-0.404、-2.220、-2.674,P<0.05);与对照组相比,观察组血β2-Mg、尿β2-Mg、尿mALb、BUN、Cys C水平明显升高,差异有统计学意义(Z=-3.069、-2.459、-3.561、-2.218、-2.669,P<0.05);Spearman秩相关分析结果显示:TSH与血β2-Mg、尿β2-Mg、尿mALb、Cys C呈正相关(rs=0.279、0.186、0.210、0.254,P<0.05)。结论 SCH对于T2DM患者的肾功能有较大影响,因此T2DM患者入院应进行甲状腺激素水平筛查,以便尽早诊断和干预SCH,以减缓糖尿病肾脏疾病的发生和发展。Objective To explore the difference of renal function between type 2 diabetes(T2DM) and T2DM with subclinical hypothyroidism(SCH). Methods 88 patients with T2DM complicated with SCH admitted from July 2020 to January 2022 were selected as the observation group. 128 patients with T2DM(normal thyroid function)in the same period were selected as the control group. The. evels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxin(FT4),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),blood β2 microglobulin(β2-Mg),urine β2 microglobulin(β2-Mg),urinary microalbumin(mALb),urea nitrogen(BUN),cystatin C(Cys C)were compared between two groups.Results Compared with the control group,the levels of TSH,TGAb,and TPOAb in the observation group were significantly increased,and the level of FT4 was significantly decreased,with statistically significant differences(Z=-12.479、-0.404、-2.220、-2.674,P<0.05). Compared with the control group,the levels of blood β2-Mg,urine β2-Mg,urine mALb,BUN,and Cys C in the observation group were significantly increased,and the differences were statistically significant(Z=-3.069、-2.459、-3.561、-2.218、-2.669,P<0.05). Spearman correlation analysis showed that TSH was positively correlated with blood β2-Mg,urine β2-Mg,urine mALb and Cys C(rs=0.279、0.186、0.210、0.254,P<0.05). Conclusion SCH has a great impact on the renal function of T2DM patients. Therefore,patients with T2DM should be screened for thyroid hormone levels in order to diagnose and intervene SCH as early as possible,and slow down the occurrence and development of diabetes kidney disease.

关 键 词：亚临床甲状腺功能减退症 2型糖尿病 甲状腺激素 肾功能 

分 类 号：R587.1[医药卫生—内分泌] R581.2[医药卫生—内科学]