血清TT_(3)水平与维持性血液透析患者合并左心室肥厚的关系  

Relationship of serum TT_(3) level and left ventricular hypertrophy in patients with maintenance hemodialysis

作　　者：陈敬涵 邹建洲[1] 张蕾[1] 沈波 曹学森 CHEN Jinghan;ZOU Jianzhou;ZHANG Lei(Department of Nephrology,Wusong Central Hospital of Baoshan District,Shanghai 200940,CHINA)

机构地区：[1]上海市宝山区吴淞中心医院(复旦大学附属中山医院吴淞医院)肾内科,200940 [2]复旦大学附属中山医院肾内科

出　　处：《江苏医药》2023年第3期255-260,共6页Jiangsu Medical Journal

摘　　要：目的探讨血清总三碘甲状腺原氨酸(TT_(3))水平与维持性血液透析(MHD)患者合并左心室肥厚(LVH)的关系。方法根据是否合并LVH,将602例MHD患者分为LVH组(260例)和对照组(342例),比较两组甲状腺功能和生化指标,采用多因素logistic回归分析MHD患者合并LVH的影响因素,采用ROC曲线分析相关指标对MHD患者合并LVH的预测价值。结果LVH组年龄高于对照组,透析龄低于对照组(P<0.05)。LVH组血清TT_(3)、白蛋白、前白蛋白和尿素清除指数(Kt/V)低于对照组(P<0.05),LDL、血磷、CRP和N末端脑钠肽前体高于对照组(P<0.05)。LVH组低T3综合征发生率高于对照组(P<0.01)。高龄和高水平CRP是MHD患者合并LVH的独立危险因素(P<0.05),高水平TT_(3)、白蛋白、前白蛋白和Kt/V是MHD患者合并LVH的保护性因素(P<0.05)。血清TT_(3)预测MHD患者合并LVH的AUC为0.893(P<0.01)。取TT_(3)0.74 nmol/L为最佳诊断界值时,其预测MHD患者合并LVH的灵敏度为73.8%,特异度为90.9%。结论血清TT_(3)水平与MHD患者合并LVH密切相关,对其有较高的预测价值。Objective To investigate the relationship of serum total triiodothyronine(TT_(3))level and left ventricular hypertrophy(LVH)in the patients with maintenance hemodialysis(MHD).Methods A total of 602 MHD patients were divided into group LVH(LVH patients,260 cases)and group C(without LVH,342 cases).The thyroid function and biochemical indexes were compared between the two groups.The influencing factors for MHD patients with LVH were analyzed by multivariate logistic regression.ROC curve was used to analyze the predictive value of relevant indicators in MHD patients with LVH.Results The age was higher and the dialysis age was lower in group LVH than those in group C(P<0.05).Serum TT_(3),albumin,prealbumin and Kt/V were lower,and LDL,blood phosphorus,CRP and NT-proBNP were higher in group LVH than those in group C(P<0.05).The incidence of low T_3 syndrome in group LVH was higher than that in group C(P<0.01).Elderly age and high level of CRP were the independent risk factors for MHD patients with LVH(P<0.05),and high levels of TT_(3),albumin,prealbumin and Kt/V were the protective factors for MHD patients with LVH(P<0.05).The area under the curve of serum TT_(3)in predicting MHD patients with LVH was 0.893(P<0.01).Taking TT_(3)0.74 nmol/L as the best diagnostic cutoff value,the sensitivity and specificity for predicting MHD patients with LVH were 73.8%and 90.9%,respectively.Conclusion Serum TT_(3)level is closely related to MHD patients with LVH and has high predictive value.

关 键 词：维持性血液透析 左心室肥厚 总三碘甲状腺原氨酸 

分 类 号：R692[医药卫生—泌尿科学]