小剂量甲状腺素对尿毒症合并正常甲状腺功能病态综合征的疗效观察

Therapeutic effect of thyroxine on patients with uremia with euthyroid sick syndrome

目的探讨尿毒症合并正常甲状腺功能病态综合征患者（ESS）应用小剂量甲状腺素的治疗效果。方法将40例尿毒症合并ESS患者随机分为两组，治疗组常规治疗基础上加用小剂量甲状腺素，对照组仅给予常规治疗。比较两组患者治疗前后血清游离三碘甲状腺原氨酸（FT4，）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、血肌酐（SCr）、尿素氮（BUN）、血清白蛋白（Alb）、血红蛋白（Hb）、红细胞压积（Hct）、体重指数（BMI）等指标的变化。结果两组患者治疗后Hb、Hct较治疗前均有所提高（P〈0．05），治疗组与对照组比较差异有统计学意义（P〈0．05）；两组患者治疗后肾功能均较治疗前有所改善（P〈0．05），但两组之间比较差异无统计学意义（P〉0．05）；治疗组患者治疗后干体重及BMI水平较治疗前及对照组均有所提高，且差异均有统计学意义（P〈0．05）。结论对尿毒症合并ESS的患者短期内补充小剂量甲状腺素能纠正贫血状态，改善营养状况，提高生活质量。

Objective To investigate the therapcutic effect of a little dose thyroxine in uremia with euthyroid sick syndrome （ESS）. Methods 40 cases who had uremia with ESS were randomly divid- ed into treatment group（ n = 20 ）and control group（ n = 20）. In treatment group patients received routine treatment and a little dose thyroxine for twelve weeks, however, the patients in control group were only treated with routine treatment. The FT3, FT4, TSH, SCr, BUN, Alb, Hb, Hct and BMI were determined be- fore and after treatment. Results Twelve weeks later,the improvements of Hb, Hct and BMI were singnif- icantly better than that in control group （ P 〈 0.05 ）. The improvement of renal function was singnificant in both groups（ P 〈 0.05 ） ;but there was no significant difference between the two groups（ P 〉 0.05 ）. Con- clusion Anemia with uremia with ESS can be improved by a little dose and short-time thyroxine.