持续不卧床腹膜透析患者低T_3综合征与微炎症和左心室肥厚的关系

Relationship between low T_3 syndrome, micro-inflammation and left ventricular hypertrophy in continuous ambulatory peritoneal dialysis patients

目的探讨持续性不卧床腹膜透析(CAPD)患者低T_3综合征与微炎症和左心室肥厚(LVH)的关系。方法选取2016年10月～2017年10月在福建省立医院腹膜透析中心的86例持续性不卧床腹膜透析(CAPD)患者,根据甲状腺素水平,分为低T_3综合征组和正常T_3组,检测两组患者的生化指标和心脏超声指标。采用Pearson相关分析法分析游离三碘甲腺原氨酸(FT_3)、C反应蛋白(CRP)和LVH的相关性。结果 86例患者中,合并低T_3综合征的CAPD患者35例(40.1%),正常T_3组51例(59.9%)。低T_3综合征组患者的血红蛋白、血清白蛋白、高密度脂蛋白水平均低于正常T_3组,差异有统计学意义(P<0.01)。低T_3综合征组的总胆固醇、三酰甘油、CRP和左心室心肌质量指数(LVMI)水平均明显高于正常T_3组,差异有统计学意义(P<0.01)。Pearson相关分析显示,FT_3与LVMI成负相关关系(r=-0.524,P<0.01),FT_3与CRP成负相关关系(r=-0.598,P<0.01),CRP与LVMI成正相关关系(r=0.830,P<0.01)。结论腹膜透析患者低T_3综合征的发生率较高,低T_3综合征和微炎症状态是腹膜透析患者左心室肥厚发生的危险因素。

Objective To investigate the relationship between low T3syndrome,micro-inflammation and left ventricular hypertrophy(LVH)in patients with continuous ambulatory peritoneal dialysis(CAPD).Methods Altogether86patients with continuous ambulatory peritoneal dialysis(CAPD)who were treated in Peritoneal Dialysis Center of Fujian Province-Owned Hospital from October2016to October2017were selected and divided into the low T3syndrome group and the normal T3group according to thyroxine levels.The biochemical indexes and echocardiographic indexes of the two groups were detected.Pearson correlation analysis was used to analyze the correlation between free triiodothyronine(FT3),C-reactive protein(CRP)and LVH.Results Among the86patients,35cases(40.1%)were CAPD patients with low T3syndrome and51cases(59.9%)were normal.The levels of hemoglobin,serum albumin and high density lipoprotein of the low T3syndrome group were lower than those of the normal T3group,with statistically significant difference(P<0.01).The levels of total cholesterol,triglyceride,CRP and left ventricular mass index(LVMI)of the low T3syndrome group were significantly higher than those of the normal T3group,with statistically significant difference(P<0.01).Pearson correlation analysis showed that FT3was negatively correlated with LVMI(r=-0.524,P<0.01),FT3was negatively correlated with CRP(r=-0.598,P<0.01),CRP and LVMI were positively correlated(r=0.830,P<0.01).Conclusion The incidence of low T3syndrome in peritoneal dialysis patients is very higher.Low T3syndrome and micro-inflammation are the risk factors for the occurrence of left ventricular hypertrophy in peritoneal dialysis patients.