原发性肾病综合征并发急性肾损伤患者甲状腺功能的变化

目的观察原发性。肾病综合征（PNS）并发急性肾损伤（AKI）患者甲状腺功能的变化及其影响因素。方法回顾性分析PNS患者77例，其中PNS并发AKI患者27例为PNS＋AKI组；PNS肾功能正常者50例为PNS组；同时设原发性慢性肾小球肾炎肾功能正常组（CGN1组）和CGN肾功能异常组（CGN2组）作为对照组，每组各40例。比较4组患者的血浆总蛋白（TP）、血清白蛋白（Alb）、血肌酐（SCr）、甘油三脂（TG）、胆固醇（TC）、24h尿蛋白定量及甲状腺功能指标游离三碘甲腺原胺酸（盯3）、游离四碘甲腺原胺酸（FT4）、促甲状腺素（TSH）。结果（1）PNS＋AKl组FT3、FT4值较各组明显降低（P〈0.05）；而TSH无明显差异（P〉0.05）。（2）PNS＋AKI组和PNS组TP、Alb、SCr有显著差异（P〉0.05）。（3）多元回归分析示Alb、SCr对FT3影响显著（P〈0.05）。结论PNS合并AKI时较PNS患者FT3、FT4明显降低，而TSH无明显变化，这种改变可能与Alb的进一步降低和肾功能损伤有关。

Thyroid function in primary nephrotic syndrome patients associated with acute kidney injury

Objective To investigate the change and associated factors of thyroid function in primary nephrotie syndrome （PNS） patients with acute kidney injury （AKI）. Methods A total of 77 PNS patients and 80 chronic nephritis patients were divided into four groups： PNS group,PNS ＋ AKI group,CGN group and CGN ＋ CKD group. The data about blood total trotein （TP）, albumin （Alb）, creatinine （SCr）, triglyceride （TG）, cholesterol （TC）, 24-h proteinuria, FT3, FT4 and TSH were determined. Results （1） FF3 and FT4 levels in PNS ＋ AKI group were significantly lower than other three groups （P〈0.05）. There were no changes in TSH among the four groups （P〉0.05）. （2）TP and Alb were lower, and SCr was higher in PNS＋ AKI group than in PNS group. （3）Multiple regres sion analysis revealed Alb and SCr values could significant impact FT3 levels. Conclusion In the PNS patients associated with acute kidney injury, FT3 and FT4 levels were significantly reduced, but TSH level had no significant change, which was related to the further reduction of Alb and renal function in jury.