作者投稿
专家审稿
编辑办公
邮件订阅
RSS
Serum Creatinine Level and Its Influencing Factors in Patients with Primary Hypothyroidism
-
摘要:
目的 探讨原发性甲状腺功能减退症(甲减)患者血清肌酐(creatinine, Cr)水平变化及其影响因素。 方法 回顾性分析北京协和医院内分泌科2006年1月至2010年12月诊治的27例甲减患者的临床资料, 并根据血清游离甲状腺素(free thyroxine, FT4)水平将患者分为临床甲减组和亚临床甲减组。使用Cockcroft-Gault公式计算患者肌酐清除率(creatinine clearance rate, CCr)。分析患者血清Cr、尿素氮、CCr与甲状腺功能以及血清肌酸激酶间的关系。 结果 14.8%的患者血清Cr水平超过正常上限。本组患者血清Cr和血清游离三碘甲腺原氨酸(free triiodothyronine, FT3)(P < 0.001, r=-0.628)、FT4(P=0.016, r=-0.458)间均呈负相关。临床甲减组血清Cr水平明显高于亚临床甲减组[(99.89±28.93)μmol/l比(74.67±8.03)μmol/l, P < 0.01]。而甲状腺激素治疗后, FT4明显升高(P=0.005), 血清Cr明显降低(P=0.001)。Cr和经对数转换的血清肌酸激酶间呈正相关(P=0.032, r=0.596), CCr和FT4呈正相关(P=0.043, r=0.527)。 结论 临床上发现血清Cr水平增高的患者应常规筛查甲状腺功能。血清Cr水平的增高与CCr的下降以及肌肉的破坏均有关。甲状腺功能纠正后, 甲减引起的血清Cr水平的增高可恢复正常。 Abstract:Objective To explore the changes of serum creatinine (Cr) level in patients with primary hypothyroidism and the influencing factors of serum Cr level. Methods We retrospectively analyzed the clinical data of 27 patients with primary hypothyroidism who were treated at Peking Union Medical College Hospital between January 2006 and December 2010. The patients were divided into two groups according to the level of serum free thyroxine (FT4), i.e. clinical hypothyroidism group and subclinical hypothyroidism group. We calculated the creatinine clearance rate (CCr) with Cockcroft-Gault Formula and analyzed the relationship of serum Cr, blood urea nitrogen, and CCr with thyroid function and serum creatine kinase (CK). Results The serum Cr levels in 14.8% of the patients exceeded the normal range. The serum levels of Cr were negtively correlated with free triiodothyronine (FT3) (P < 0.0001, r=-0.628) and FT4 (P=0.016, r=-0.458). The serum Cr level in the clinical hypothyroidism group was higher than in the subclinical hypothyroidism group[(99.89±28.93)μmol/L vs. (74.67±8.03)μmol/L, P < 0.01]. After thyroxine treatment, the serum level of FT4 significantly increased (P=0.005) while the serum level of Cr significantly decreased (P=0.001). The serum Cr level was positively correlated with lnCK(P=0.032, r=0.596), and CCr was positively correlated with FT4(P=0.043, r=0.527). Conclusions Routine screening of thyroid function is recommended in patients with elevated serum Cr level. An increased serum Cr level is correlated with both the decrease of CCr and the damage of muscles. The level of serum Cr elevated due to hypothyroidism could return to normal range when the thyroid function recovers. -
Key words:
- hypothyroidism /
- serum creatinine /
- creatine kinase
-
表 1 27例甲减患者甲状腺功能和血清Cr、BUN水平 $\left[ {(\overline x \pm s/M({Q_1},{Q_3})} \right]$
分组 例数 FT3(pmol/L) FT4(pmol/L) TSH(mU/L) Cr(μmol/L) BUN(mmol/L) 临床甲减 18 1.89±1.11 5.55±2.32 123.40±43.88 99.89±28.93 4.58±1.05 亚临床甲减 9 3.62±0.69* 13.67±3.10* 27.50(8.12, 48.25)* 74.67±8.03* 3.99±0.96 总计 27 2.46±1.40 8.27±4.64 96.10±59.20 91.50±26.70 5.05±3.66 Cr、FT3：同图 1；FT4：同图 2；TSH：促甲状腺激素；BUN：尿素氮；与临床甲减组比较，*P < 0.01 
下载: 导出CSV
-
[1] 白耀.甲状腺功能减退症[M]//史轶蘩.协和内分泌代谢学.北京: 科学出版社, 1999: 1042. [2] Dousdampanis P, Trigka K, Vagenakis GA. The thyroid and the kidney:a complex interplay in health and disease[J]. Int J Artif Organs, 2014, 37:1-12. doi: 10.5301/ijao.5000300 [3] 丁奇龙.甲状腺功能减退症引起肾功能改变二例[J].中华内分泌代谢杂志, 2000, 16:192. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhnfmdx200003022 [4] Inal BB, Oguz O, Emre T. Evaluation of MDRD, Cockcroft-Gault, and CKD-EPI formulas in the estimated glomerular filtration rate[J]. Clin Lab, 2014, 60:1685-1694. http://smartsearch.nstl.gov.cn/paper_detail.html?id=86fb9aba432245517a151e58c87433db [5] 甲状腺功能减退症[M]//滕卫平, 曾正陪.中国甲状腺疾病诊治指南. 2版.北京: 中华医学会内分泌学分会, 2008: 40. [6] Meuwese CL, Gussekloo J, de Craen AJ. Thyroid status and renal function in older persons in the general population[J]. J Clin Endocrinol Metab, 2014, 99:2689-2696. doi: 10.1210/jc.2013-3778 [7] 常用肾脏功能检测[M]//陈友彬.诊断学.7版.北京: 人民卫生出版社, 2008: 349-350. [8] Kreisman SH, Hennessey JV. Consistent reversible elevations of serum creatinine levels in severe hypothyroidism[J]. Arch Intern Med, 1999, 159:79-82. doi: 10.1001/archinte.159.1.79 [9] Brueckner D, Brueckner MM. Renal impairment resulting from hypothyroidism-or impaired estimated glomerular filtration rate in a patient with hypothyroidsm[J]. NDT Plus, 2009, 2:262-263. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=HighWire000001850451 [10] 心肌酶和心肌蛋白检测[M]//陈友彬.诊断学.7版.北京: 人民卫生出版社, 2008: 391-392. -
点击查看大图
图(2) / 表(2)
计量
- 文章访问数: 155
- HTML全文浏览量: 66
- PDF下载量: 10
- 被引次数: 0
