维持性血液透析和腹膜透析患者甲状腺功能及甲状腺结节发生率对比研究  

Comparison of thyroid function and thyroid nodule between patients with ESRD on hemodiaysis and peritoneal dialysis

作　　者：赵彩霞[1] 许琴[1] 曹娟[1] 李海涛[1] 章旭[1] ZHAO Caixia;XU Qin;CAO Juan;LI Haitao;ZHANG Xu(Department of Nephrology,Taixing People’s Hospital,Taixing,Jiangsu 225400,China)

机构地区：[1]江苏省泰兴市人民医院肾内科,225400

出　　处：《重庆医学》2023年第S01期114-116,共3页Chongqing medicine

摘　　要：目的比较维持性血液透析(MHD)和腹膜透析(PD)患者甲状腺功能异常及甲状腺结节发病率的差异。方法选取2018年10月31日至2021年10月31日该院透析中心收治的长期MHD患者120例(MHD组)和PD患者110例(PD组)作为研究对象,均为透析时间>3个月且病情稳定者,排除甲状腺功能亢进和甲状腺功能减退者;另选取40例健康体检者作为对照组。收集各组研究对象临床资料,包括透析龄、性别、年龄、用药、原发疾病及生化检查结果,使用电化学发光仪检测各组研究对象甲状腺功能,包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)等,并进行甲状腺彩色多普勒超声检测甲状腺结节发生情况。结果MHD、PD组性别、年龄、透析龄、原发疾病、血红蛋白、血浆清蛋白、血钙、血磷、甲状旁腺激素比较,差异均无统计学意义(P>0.05);与对照组比较,MHD、PD组血浆FT4、FT3水平均明显更低,差异均有统计学意义(P<0.05),且以低三碘甲腺原氨酸(T3)为主;MHD、PD组血浆TSH水平与对照组比较,差异无统计学意义(P>0.05);MHD组FT3、FT4、TSH水平与PD组比较,差异均无统计学意义(P>0.05);MHD、PD组甲状腺功能异常发生率均明显对照组,且MHD组甲状腺功能异常发生率明显高于PD组,差异均有统计学意义(P<0.05),且MHD、PD组甲状腺功能异常主要以低T3为主。与对照组比较,MHD、PD组甲状腺结节发生率均明显更高,且MHD组甲状腺结节发生率明显高于PD组,差异均有统计学意义(P<0.05)。结论MHD、PD患者甲状腺功能异常发生率和甲状腺结节发生率均高于健康体检者,且MHD组甲状腺功能异常和甲状腺结节发生率明显高于PD组。Objective To compare the prevalence of thyroid dysfunction and thyroid nodule between patients with maintenance hemodiaysis(MHD)and peritoneal dialysis(PD).Methods 120 MHD patients in our hemodialysis center and 110 PD patients in our PD center were recruited for research.All cases were patients with more than three months of dialysis time and stable condition.All of them were without clinical hyperthyroidism and clinical hypothyroidism.And 40 healthy subjects were control group.Collect the clinical data of the two groups including dialysis time,gender,age,protopathy and clinical test results,detect the thyroid function,including free FT3,free T4 and thyroid-stimulating hormone(TSH).And the thyroid nodules were examed with color doppler ultrasound.Results Gender,age,dialysis duration,hemoglobin,primary disease,plasma albumin,serum calcium,serum phosphorus and parathyroid hormone were not significantly different between MHD and PD groups(P>0.05).Compared with the control group,the concentration level of free FT3 and free T4 in MHD and PD groups were significantly reduced(P<0.05).while plasm Concentration of TSH were not significantly different(P>0.05).The incidence of thyroid dysfunction in MHD patients was 43%,PD group was 25%,the two groups were apparently higher than the control group which was 6.5%.Examed with color doppler ultrasound,the incidence of thyroid nodules in the control group was 7%,MHD patients was 35%significantly higher than the control group,and PD group was also 18%significant higher.Conclusion The incidence of thyroid dysfunction and thyroid nodules in MHD and PD patients were all higer than the control group,and the incidence of MHD group was significant higher.than the PD group.

关 键 词：维持性血液透析 腹膜透析 甲状腺功能 甲状腺结节 

分 类 号：R581[医药卫生—内分泌] R692.5[医药卫生—内科学]