低三碘甲状腺原氨酸综合征与恶性肿瘤患者低蛋白血症严重程度的相关性研究

Study on correlation between low triiodothyronine syndrome and severity of hypoproteinemia in patients with malignant tumor

目的分析低三碘甲状腺原氨酸(T3)综合征与恶性肿瘤患者低蛋白血症严重程度的相关性。方法回顾性分析2020年9-11月该院收治的恶性肿瘤患者106例,根据血清T3、游离三碘甲状腺原氨酸(FT3)、反三碘甲状腺原氨酸(rT3)水平将其分为低T3组(74例)和非低T3组(32例)。另选取同期健康体检者21例作为健康对照组。根据血清清蛋白水平,将全部127例研究对象分为正常清蛋白组(75例)、轻度低蛋白血症组(25例)、中度低蛋白血症组(25例)、重度低蛋白血症组(2例)。检测各组入院时血清甲状腺激素及血清总蛋白、清蛋白、前清蛋白、血糖水平,分析低T3综合征与恶性肿瘤患者血清蛋白的相关性。结果低T3组、非低T3组和健康对照组T3、FT3、rT3水平比较,差异有统计学意义(P<0.05),而甲状腺素(T4)、促甲状腺激素(TSH)、游离甲状腺素(FT4)水平比较,差异无统计学意义(P>0.05);低T3组总蛋白、清蛋白、前清蛋白水平均低于非低T3组、健康对照组,差异有统计学意义(P<0.01);Spearman相关性分析显示,血清T3与低蛋白血症严重程度呈正相关(r=0.419,P<0.001);FT3与低蛋白血症严重程度呈正相关(r=0.684,P<0.001);rT3与低蛋白血症严重程度呈负相关(r=-0.541,P<0.001);TSH、T4、FT4与总蛋白、清蛋白、前清蛋白无相关性(P>0.05)。结论低T3综合征恶性肿瘤患者易发生低蛋白血症,血清T3、FT3水平与低蛋白血症严重程度呈正相关,rT3水平与低蛋白血症严重程度呈负相关。

Objective To analyze the correlation between low triiodothyronine(T3)syndrome and the severity of hypoproteinemia in patients with malignant tumor.Methods A retrospective analysis was performed on 106 patients with malignant tumor admitted to this hospital from September to November 2020.The patients were divided into low T3 group(74 cases)and non-low T3 group(32 cases)according to the serum levels of T3,free triiodothyronine(FT3),and reverse triiodothyronine(rT3).Another 21 healthy subjects were selected as healthy control group.According to serum albumin level,all 127 subjects were divided into normal albumin group(n=76),mild hypoproteinemia group(n=25),moderate hypoproteinemia group(n=26)and severe hypoproteinemia group(n=2).Thyroid function,serum total protein,albumin,prealbumin and blood glucose levels were detected at admission in each group.Thyroid hormone levels in low T3 group,non-low T3 group and healthy control group were analyzed,as well as the correlation between low T3 syndrome and serum protein in patients with malignant tumor.Results There were statistically significant differences in T3,FT3 and rT3 levels between low T3 group,non-low T3 group and healthy control group(P<0.05),while there was no statistically significant differences in thyroxine(T4),thyroid stimulating hormone(TSH)and free thyroxine(FT4)levels(P>0.05).The levels of total protein,albumin and prealbumin in low T3 group were lower than those in non-low T3 group and healthy control group,the differences were statistically significant(P<0.01).Spearman correlation analysis showed that serum T3 positively correlated with the severity of hypoproteinemia(r=0.419,P<0.001).FT3 positively correlated with the severity of hypoproteinemia(r=0.684,P<0.001),while rT3 negatively correlated with the severity of hypoproteinemia(r=-0.541,P<0.001).TSH,T4 and FT4 had no correlation with total protein,albumin and prealbumin(P>0.05).Conclusion Malignant tumors patients with low T3 syndrome are prone to hypoproteinemia.Serum T3 and FT3 levels positively correlated with the severity of hypoproteinemia,while rT3 levels negatively correlated with the severity of hypoproteinemia.