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目的:探讨慢性肾脏病非透析患者血游离三碘甲腺原氨酸(FT_3)对左心室肥厚(LVH)的影响。方法:回顾性地分析2006年11月至2009年3月在本院肾内科住院治疗的43例慢性肾脏病非透析患者的临床资料。根据左心室质量指数(LVMI)将患者分为两组,即LVH组(24例)和非LVH组(19例),比较两组血甲状腺激素谱及其他指标的不同,并采用多元线性回归模型探讨血FT_3对LVMI的独立影响作用。结果:与非LVH组相比,LVH组患者估计肾小球滤过率[eGFR,(10.2±10.0)mL/(min·1.73 m~2)vs 20.8±14.5 mL/(min·1.73 m~2),P<0.05]、血红蛋白[HGB,(71.8±17.6)g/L vs 102±25.3 g/L,P<0.001和血白蛋白[ALB,(32.8±4.9)g/L vs(37.1±5.8)g/L,P<0.05]更低,而血磷水平[(1.98±0.62)mmol/L vs(1.28±0.31)mmol/L,P<0.001]则更高。同时LVH患者还呈现更低的血FT_3水平[(2.34±0.83)pmol/Lvs(3.17±0.68)pmol/L,P<0.05]和更高的低T3综合征发生率(50%vs 14.3%,P<0.05)。多因素分析显示血FT_3和血磷能独立地影响LVMI的水平(R~2=0.650,P<0.001)。结论:慢性肾脏病非透析患者存在较高的低T_3综合征和LVH发生率,并且低的血FT_3对于LVH具有独立的影响作用。
Objective: To investigate the effect of free triiodothyronine (FT_3) on left ventricular hypertrophy (LVH) in non-dialysis patients with chronic kidney disease. Methods: The clinical data of 43 patients with chronic kidney disease who were hospitalized in our hospital from November 2006 to March 2009 were retrospectively analyzed. According to the left ventricular mass index (LVMI), the patients were divided into two groups: the LVH group (24 cases) and the non-LVH group (19 cases). The differences of thyroid hormone spectrum and other indexes were compared between the two groups. Multivariate linear regression model To investigate the independent effect of blood FT_3 on LVMI. Results: Compared with non-LVH group, glomerular filtration rate (eGFR, 10.2 ± 10.0 mL / (min · 1.73 m 2) vs 20.8 ± 14.5 mL / (min · 1.73 m 2 ), P <0.05], hemoglobin [(71.8 ± 17.6) g / L vs 102 ± 25.3 g / L, P <0.001 and albumin [ALB, (32.8 ± 4.9) g / L vs. (37.1 ± 5.8) ) g / L, P <0.05], while the level of serum phosphorus was higher (1.98 ± 0.62 mmol / L vs 1.28 ± 0.31 mmol / L, P <0.001). At the same time, LVH patients also showed lower blood FT 3 levels (2.34 ± 0.83 pmol / L vs 3.17 ± 0.68 pmol / L, P 0.05 and higher incidence of low T3 syndrome 50% vs 14.3% P <0.05). Multivariate analysis showed that blood FT_3 and blood phosphorus independently influenced the level of LVMI (R ~ 2 = 0.650, P <0.001). Conclusion: Non-dialysis patients with chronic kidney disease have a high incidence of low T 3 syndrome and LVH, and low blood FT 3 has an independent effect on LVH.