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目的:探讨肾病综合征继发甲状腺激素异常的变化规律及临床意义。方法:用放射免疫法检测血FT3、FT4、TSH,24 h尿蛋白定量用终点法,用溴甲酚绿终点法测血清白蛋白。结果:PNS急性期组患儿血FT3、FT4均低于对照组,差异有统计学意义(P<0.01);PNS急性期与恢复期血FT3、FT4比较差异有统计学意义(P<0.01),PNS恢复期血FT3、FT4、TSH与对照组比较差异无统计学意义。PNS急性期血FT3与24 h尿蛋白呈显著负相关(P<0.05),与血清白蛋白呈显著正相关(P<0.05);血FT4与24 h尿蛋白呈负相关(P<0.05),与血清白蛋白呈正相关(P<0.01)。结论:PNS患儿可出现继发性、暂时性甲状腺激素水平的下降,多数患儿随病情好转而恢复,部分患儿对糖皮质激素疗效不佳的加用甲状腺片口服,促进了尿蛋白转阴。动态观察甲状腺激素的变化对估计病情、判断预后及指导治疗有一定临床价值。
Objective: To investigate the changes and clinical significance of thyroid hormone abnormalities secondary to nephrotic syndrome. Methods: The blood levels of FT3, FT4, TSH and 24 h urinary protein were determined by radioimmunoassay and the serum albumin was measured by bromocresol green end-point method. Results: The levels of FT3 and FT4 in children with PNS in the acute phase were lower than those in the control group (P <0.01), and there was significant difference in the FT3 and FT4 between the acute and congestive phases of PNS (P <0.01) , PNS convalescent blood FT3, FT4, TSH compared with the control group no significant difference. There was a significant negative correlation between serum FT3 and 24 h urinary protein in PNS (P <0.05) and serum albumin in PNS acute phase (P <0.05), and negative correlation between FT4 and 24 h urine protein (P <0.05) And serum albumin was positively correlated (P <0.01). Conclusion: Secondary and transient thyroid hormone levels may decline in children with PNS. Most children recover with the improvement of their condition. Some children take orally oral administration of thyroid tablets with poor curative effect of glucocorticoids and promote urinary protein turnover yin. Dynamic observation of thyroid hormone changes in the estimation of disease, prognosis and guide the treatment of a certain clinical value.