关键词:  终末期肾病, 血液透析, 甲状腺功能, C反应蛋白质

Abstract:

ABSTRACT Objective：To investigate the changes of thyroid function and cardiac structure in patients on maintenance hemodialysis （MHD）. Methodology：One hundred patients with end-stage renal disease (ESRD), who had been on hemodialysis for more than three months, were enrolled into this study. According to the thyroid function, they were divided into thyroid dysfunction group and euthyroidism group. Their clinical data and biochemical indicators were collected. The concentrations of serum free-T3 (FT3), free-T4 (FT4) and thyrotropin (TSH) were measured by electrochemiluminescence．The left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDd), left ventricular end-diastolic dimension (LVEDs), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) ,left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and relative wall thickness (RWT) were measured by ultrasonic cardiography. The associations between the changes of cardiac structure and thyroid function were analyzed. The levels of plasma homocysteine (Hcy) and C-reactive protein (CRP) were also detected. Results：Among these 100 patients, 49(49%) had thyroid dysfunction. The concentration of Hcy and CRP were significantly higher in thyroid dysfunction group than those in euthyroidism group (P <0.05). LAD, LVEDd, LVEDs, LVPWT, IVST, RWT and LVMI were higher (P <0.05), while LVEF was lower (P <0.01) in thyroid dysfunction group than those in euthyroidism group. Multivariate logistic regression analysis showed that the lower serum FT3 1evel was an independent risk factor for left ventricular hypertrophy. Conclusion：Thyroid dysfunction with low serum FT3 was frequently found in MHD patients. FT3 of patients with MHD was negatively correlated to their left ventricular mass index.

Key words:  end-stage renal disease, hemodialysis, thyroid function, C-reactive protein