血液透析对血清甲状腺激素和促甲状腺素水平的影响及意义

Effects of Hemodialysis on the Serum Thyroid Hormone and TSH Levels

  • 摘要: 本文介绍了用放射免疫法测定的43和67例正常人、35例尿毒症患者(保守治疗组14例、血液透析治疗组21例)血清游离T3(FT3)、游离T4(FT4)、总T3(TT3)、总T4(TT4)和促甲状腺素(TSH1RMA)水平,观察到虽然尿毒病患者甲状腺功能正常,但是血清FT3、FT4和TT3平均水平明显降低,TT4和TSH1RMA正常。FT3、FT4、TT3和TT4低于正常值的出现频率,在保守治疗组分别为35.7、42.9、50和21%,在血透治疗组分别为81、38.1、61.9和14.2%。一次性透析后血清TSH1RMA水平明显降低而血清FT3、FT

     

    Abstract: Serum levels of free T3(FT3), free T4(FT4), total T3(TT3), total T4(TT4) and TSHIRLA were measured in 43 and 67 normal subjects, 35 uremic patients (conservative 14, hemodialysis ones 21). Significamly lowered mean serum FT3, FT4 and TT3 but normal T4 and TSHIRMA were observed in untreated uremic and hemodialysis ones, although all the subjects were euthyroid. The rates of low FT3, FT4, TT3 and TT4 were 37.5, 42.9, 50 and 21% in conservative uremic patients and 81, 38.1, 61.9 and 14.2% in hemodialysis patients respectively. The postdialysis TSHIRMA level was significantly reduced and FT3, FT4, TT3 and TT4 were unchanged after transient hemodialysis. There was no change of the rates of low FT3, FT4, TT3 and TT4 in the couse of maintained dialysis.
    The conclusion is that FT3, FT4, TT3 and TT4 are lowered in parts of conservative uremic and hemodialysis patient but TSHIRMA is normal or only slightly low. The thyroid function of them is most likely normal (euthyroid). TSHIRMA is a useful index in diagnosing hypothyroidism in uremic and hemodialysis patients. Transient and maintained hemodialysis do not dramaticaly change the thyroid hormone and TSHIRMA levels.

     

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