2型糖尿病肾病严重程度与甲状腺功能的相关性研究

The correlation analysis between type 2 diabetic nephropathy severity and thyroid function

目的：探讨2型糖尿病肾病（DN ）严重程度与甲状腺功能之间的关系。方法选择住院2型糖尿病肾病患者120例，其中，DN Ⅲ期、Ⅳ期、Ⅴ期各40例，另选40例NDN患者作为对照（NDN）。比较各组血浆白蛋白、血红蛋白、血钾、甲状腺功能，并进行相关性分析。结果Ⅲ、Ⅳ和Ⅴ期患者血浆白蛋白分别为（41．3±3．6）g／L、（30．5±4．8）g／L和（28．3±5．9）g／L，均低于NDN组（F＝11．36，P＜0.05）；Ⅲ、Ⅳ和Ⅴ期患者24 h尿蛋白分别为（0．48±0．29）g、（1．86±0．54）g 和（1．69±0．67）g，均高于 NDN 组（F＝7.12，P＜0.05）；Ⅲ、Ⅳ和Ⅴ期患者三碘甲腺原氨酸（T3）分别为（0．98±0．38）nmol／L、（0．75±0．41）nmol／L和（0.60±0．28）nmol／L，均低于 NDN 组（F ＝7．64，P ＜0．05）；Ⅲ、Ⅳ和Ⅴ期患者甲状腺素（T4）分别为（6．06± 1．76）nmol／L、（5．31±1．98）nmol／L和（4．65±1．87）nmol／L，均低于NDN组（F＝6．83，P＜0.05）；Ⅲ、Ⅳ和Ⅴ期患者游离型三碘甲腺原氨酸（FT3）分别为（4．37±2．12）pmol／L、（3．33±2．30）pmol／L 和（2．91± 1．82）pmol／L，均低于NDN组，差异有统计学意义（F＝7．14，P＜0．05）；等级相关性分析结果提示，FT3是DN严重程度的独立预测因子。结论 DN患者存在不同程度甲状腺功能异常，测定甲状腺激素水平，有助于了解糖尿病肾病病情。

Objective To analyze the relationship between thyroid function and grades of diabetic nephropa-thy （DN）.Methods One hundred and twenty patients with definite DN were classified into the four groups,and forty patients with non-DN diabetic was NDN group.Their serum albumin,blood hemoglobin,serum potassium,functional parameters of thyroid and dependability to DN were analyzed.Results The plasma albumin ofⅢ,Ⅳ and Ⅴ group were （41.3 ±3.6）g/L,（30.5 ±4.8）g/L and （28.3 ±5.9）g/L,which were lower than those of NDN group （F=11.36,P〈0.05）.24h urine protein ofⅢ,Ⅳ and Ⅴ were （0.48 ±0.29）g,（1.86 ±0.54）g and （1.69 ±0.67）g, which were higher than those of group NDN （F=7.12,P〈0.05）.Triiodothyronine（T3）ofⅢ,ⅣandⅤgroup were （0.98 ±0.38）nmol/L,（0.75 ±0.41）nmol/L and （0.60 ±0.28）nmol/L,which were lower than those of NDN group （F=7.64,P〈0.05）.Tetraiodothyronine（T4）of III,IV and V group were （6.06 ±1.76）nmol/L,（5.31 ±1.98）nmol/L and （4.65 ±1.87）nmol/L,which were lower than those of NDN group （F=6.83,P〈0.05 ）.Free Triiodothyronine （FT3）ofⅢ,Ⅳ and Ⅴ group were （4.37 ±2.12）pmol/L,（3.33 ±2.30）pmol/L and （2.91 ±1.82）pmol/L, which were lower than those of NDN group （F=7.14,P〈0.05 ）.Correlation analysis indicated that FT3 was an independent predictor for the severity of diabetic nephropathy.Conclusion In the patients with DN Ⅳ and Ⅴ,DN has attained a very severe status and the treatment of DN should be intensive.