原发性肾病综合征合并非甲状腺疾病综合征患者甲状腺功能与主要生化指标相关性分析

Study on the correlation between thyroid function and biochemical parameters in patients with primary nephrotic syndrome associated with non thyroid disease syndrome

目的研究分析原发性肾病综合征(PNS)合并非甲状腺疾病综合征(NTIS)患者甲状腺功能与主要生化指标的相关性。方法回顾性选取2013年11月至2016年11月首都医科大学附属北京友谊医院收治80例原发性肾病综合征合并NTIS患者,以及同时期住院的甲状腺功能正常的PNS患者80例。观察两组患者BMI、24 h尿蛋白以及血清白蛋白等水平;观察甲状腺功能和肾功能各项指标的相关性;观察甲状腺功能和各个炎症指标、BMI之间的相关性;观察甲状腺功能和血清白蛋白以及24 h尿蛋白水平的相关性。结果两组患者24 h尿蛋白以及血清白蛋白等各项指标水平比较,差异具有统计学意义(P<0.05)。线性回归分析显示,FT3分别和Ccr(r=0.316,P<0.05),Cys C(r=0.317,P<0.05)之间呈现正相关关系。然而和BUN以及Cr之间没有相关性(P>0.05)。T3和BUN之间呈现出负相关关系(r=-0.405,P<0.05),然而和其它指标之间没有关系。FT4和T4与其余指标之间没有显著的相关性。FT3分别和CRP(r=-0.417,P<0.05),ESR(r=-0.304,P<0.05)之间呈现负相关关系。然而和白细胞以及BMI之间没有相关性(P>0.05)。T3和ESR之间呈现出负相关关系(r=-0.425,P<0.05),然而和其它指标之间没有关系。FT4和CRP(r=-0.368,P<0.05)、ESR(r=-0.331,P<0.05)以及BMI(r=-0.371,P<0.05)之间具有负相关关系,与白细胞之间无明显关系。T4与CRP(r=-0.333,P<0.05)以及ESR(r=-0.401,P<0.05)之间具有负相关关系。FT3分别和白蛋白(r=0.495,P<0.05)之间呈现正相关关系。T3和白蛋白之间呈现出正相关关系(r=0.658,P<0.05)。FT4和白蛋白(r=0.365,P<0.05)之间具有正相关关系。T4与白蛋白(r=0.585,P<0.05)之间具有正相关关系,且都与尿蛋白之间不具有相关性。结论低甲状腺激素水平或许会促进PNS合并NTIS患者的肾功能受损情况,NTIS或许是PNS对于营养不佳的一种保护机制,炎性状态是PNS患者并发NTIS的一个危险因素。

Objective To study the correlation between thyroid function and main biochemical parameters in patients with primary nephrotic syndrome associated with non-thyroid disease.Methods 80 patients with primary nephrotic syndrome associated with non thyroid disease in this hospital during November 2013 to November 2016 were enrolled in this study,and in the same period,80 patients with PNS and normal thyroid function in this hospital were studied.The level of BMI,serum level of albumin and amount of 24 h urinary protein were observed in these two groups.The correlation between thyroid function and indicators of renal function had been observed;and the correlation between thyroid function and various inflammatory markers and BMI were listed in control group.The correlation between thyroid function and serum level of albumin and amount of 24 h urinary protein were observed.Results The difference in amount of 24 h urine protein and serum level of albumin between these two groups was significant(P<0.05).Linear regression analysis showed that level of FT3 was positively correlated with Ccr(r=0.316,P<0.05)and CysC(r=0.317,P<0.05).However,there was no correlation between Bun and Cr(P>0.05).There was a negative correlation between T3 and T4(r=-0.405,P<0.05),but there was no relationship among other indicators.There was no significant correlation between Ft4 and T4.Ft3 and CRP(r=-0.417,P<0.05),ESR(r=-0.304,P<0.05)showed a negative correlation.However,there was no correlation between number of leukocytes and BMI(P>0.05).There was negative correlation between T3 and ESR(r=-0.425,P<0.05),but there was no relationship among other indicators.FT4 and CRP(r=-0.368,P<0.05),ESR(r=-0.331,P<0.05)and BMI(r=-0.401,P<0.05)had no obvious relationship with number of leukocytes.T4 and CRP(r=-0.333,P<0.05)and ESR(r=-0.401,P<0.05)had a negative correlation.Ft3 showed positive correlation with albumin(r=0.495,P<0.05).There was positive correlation between T3 and serum albumin(r=0.658,P<0.05).FT4 and serum albumin(r=0.365,P<0.05)had positive correlation.The relationship between T4 and albumin(r=0.585,P<0.05)was positive.There was no correlation with urine protein.Conclusion Low levels of thyroid hormones may promote the PNS mergering thyroid illness syndrome(NTIS)in patients with renal impairment,NTIS or PNS perhaps may be a protective mechanism for poor nutrition,inflammatory status is a risk factor for concurrent NTIS in PNS patients.