慢性腎臟�。–KD-5期）患者微炎癥狀態(tài)與甲狀腺功能的相關(guān)性研究
發(fā)布時(shí)間：2019-02-14 21:15
【摘要】：目的：探討慢性腎臟�。–KD-5期）患者微炎癥狀態(tài)與甲狀腺功能的相關(guān)性。通過(guò)本實(shí)驗(yàn)測(cè)定CKD-5期患者甲狀腺激素的水平及其與機(jī)體微炎癥狀況相關(guān)指標(biāo)的相關(guān)性研究，評(píng)估尿毒癥微炎癥狀態(tài)對(duì)甲狀腺功能的影響。 方法：選擇2013年1月-2014年1月在青海大學(xué)附屬醫(yī)院腎臟內(nèi)科治療的慢性腎臟(CKD-5期)患者60例作為實(shí)驗(yàn)組，分為透析組和非透析組，每組各30例。入選者均符合2002年美國(guó)K/DOQI關(guān)于CKD定義及分期標(biāo)準(zhǔn)，血液透析患者透析時(shí)間介于6個(gè)月到2年之間，所選患者近期均無(wú)肺部近期感染病史、無(wú)原發(fā)性甲狀腺疾病、無(wú)惡性腫瘤病史，一般情況可。另再選取年齡及性別與實(shí)驗(yàn)組匹配的青海大學(xué)附屬醫(yī)院體檢中心健康體檢者30例作為對(duì)照組，且均無(wú)心肺疾病，肝腎功能正常。各組的年齡、性別構(gòu)成相比較，差別無(wú)統(tǒng)計(jì)學(xué)意義，具有可比性。應(yīng)用SPSS17.0軟件包進(jìn)行統(tǒng)計(jì)分析，計(jì)量資料以x士s表示，不同組別之間采用單因素方差分析，相關(guān)性采用直線相關(guān)分析，檢驗(yàn)標(biāo)準(zhǔn)a=0.05,以P＜0.05為有統(tǒng)計(jì)學(xué)意義。 結(jié)果：1、實(shí)驗(yàn)組與對(duì)照組血清甲狀腺激素、ALB、CRP比較（P＜0.05），差別有統(tǒng)計(jì)學(xué)意義，提示實(shí)驗(yàn)組的血清甲狀腺激素水平、血清ALB水平均低于對(duì)照組，血清CRP水平均高于對(duì)照組；透析組與非透析組比較（P＜0.05），差別有統(tǒng)計(jì)學(xué)意義。2、實(shí)驗(yàn)組相關(guān)指標(biāo)的相關(guān)分析：血清甲狀腺激素與ALB呈正相關(guān)（P＜0.05），，與血清CRP呈負(fù)相關(guān)（P＜0.05）。 結(jié)論：1、在終末期腎病患者中，甲狀腺激素水平、血清ALB水平相對(duì)于健康人明顯降低，血清CRP水平相對(duì)于健康人明顯升高，而透析后患者的甲狀腺激素水平、血清ALB水平相對(duì)于非透析患者明顯升高，血清CRP水平相對(duì)于非透析患者明顯降低，以上可提示在終末期腎病患者中存在著非甲狀腺疾病引起的甲狀腺功能改變及微炎癥癥狀，且合并白蛋白低下，而患者在接受透析治療后上述癥狀比非透析時(shí)明顯減輕。透析后患者的一般狀況得到改善的原因可能與水負(fù)荷的減輕、炎癥因子的有效清除、毒素的清除等有關(guān)。因此，當(dāng)慢性腎臟病患者發(fā)展到終末期時(shí)，該研究可以為我們及早采取血液透析干預(yù)治療措施減少以上并發(fā)癥的發(fā)生提供一定的臨床參考，進(jìn)一步可減少因機(jī)體甲狀腺功能改變可能帶來(lái)的相關(guān)并發(fā)癥的發(fā)生。2、在終末期腎病患者中，血清甲狀腺激素與血清CRP呈負(fù)相關(guān)，與血清ALB呈正相關(guān)，可提示患者的甲功改變與微炎癥狀態(tài)的嚴(yán)重程度有一定的關(guān)系，因此，可為透析人群積極采取臨床干預(yù)措施，如應(yīng)用生物相容性高的透析膜等降低微炎癥狀態(tài)的發(fā)生或補(bǔ)充白蛋白等，進(jìn)而防止甲功改變可能會(huì)導(dǎo)致的甲狀腺激素減少進(jìn)一步引起相關(guān)癥狀的發(fā)生及加重提供相關(guān)依據(jù)。
[Abstract]:Objective: to investigate the correlation between microinflammation and thyroid function in patients with chronic kidney disease (CKD-5). In order to evaluate the effect of uremic microinflammation on thyroid function, the level of thyroid hormone and the correlation between thyroid hormone levels and microinflammation in patients with CKD-5 were studied in this study. Methods: from January 2013 to January 2014, 60 patients with chronic kidney (CKD-5) treated in Department of Renal Medicine, affiliated Hospital of Qinghai University, were divided into two groups: dialysis group (n = 30) and non-dialysis group (n = 30). All the selected patients were in accordance with the definition and staging of CKD by K/DOQI in 2002. The duration of hemodialysis was between 6 months and 2 years. The selected patients had no recent history of pulmonary infection and no primary thyroid disease. No history of malignant tumor, general situation can. In addition, 30 healthy persons in the physical examination center of Qinghai University affiliated Hospital matched with the experimental group were selected as the control group, and all of them had no heart lung disease and normal liver and kidney function. The age and sex composition of each group had no statistical significance and was comparable. The statistical analysis was carried out by using SPSS17.0 software package. The measurement data were expressed as x + s, single factor analysis of variance and linear correlation analysis were adopted among different groups. The test standard a0.05 was statistically significant (P < 0. 05). Results: 1. There were significant differences in serum thyroid hormone and ALB,CRP between the experimental group and the control group (P < 0. 05), which indicated that the serum thyroid hormone level and serum ALB level in the experimental group were lower than those in the control group. The level of serum CRP was higher than that of control group. There was significant difference between dialysis group and non-dialysis group (P < 0. 05). 2. Correlation analysis of serum thyroid hormone and ALB in experimental group was positive (P < 0. 05). There was a negative correlation with serum CRP (P < 0. 05). Conclusions: 1. The levels of thyroid hormone, serum ALB and serum CRP in patients with end-stage nephropathy were significantly lower than those in healthy subjects, while the levels of thyroid hormones in dialysis patients were significantly higher than those in healthy subjects. Serum ALB level was significantly higher than that in non-dialysis patients, and serum CRP level was significantly lower than that in non-dialysis patients. These results suggest that there are thyroid functional changes and microinflammatory symptoms caused by non-thyroid diseases in patients with end-stage nephropathy. These symptoms were significantly alleviated after dialysis treatment than in non-dialysis patients. The improvement of general condition after dialysis may be related to the reduction of water load, the effective clearance of inflammatory factors, and the clearance of toxins. Therefore, when the patients with chronic kidney disease develop to the end stage, this study can provide a certain clinical reference for us to take early intervention measures of hemodialysis to reduce the occurrence of the above complications. In patients with end-stage nephropathy, serum thyroid hormone was negatively correlated with serum CRP, and positively correlated with serum ALB. It can be concluded that the changes of thyroid function of the patients are related to the severity of microinflammation, therefore, the clinical intervention measures can be taken actively for the dialysis population. For example, the application of highly biocompatible dialysis membrane can reduce the occurrence of microinflammation or supplement albumin, so as to prevent the decrease of thyroid hormone which may lead to the decrease of thyroid hormone, which may lead to the occurrence and aggravation of related symptoms.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692
本文編號(hào)：2422614
[Abstract]:Objective: to investigate the correlation between microinflammation and thyroid function in patients with chronic kidney disease (CKD-5). In order to evaluate the effect of uremic microinflammation on thyroid function, the level of thyroid hormone and the correlation between thyroid hormone levels and microinflammation in patients with CKD-5 were studied in this study. Methods: from January 2013 to January 2014, 60 patients with chronic kidney (CKD-5) treated in Department of Renal Medicine, affiliated Hospital of Qinghai University, were divided into two groups: dialysis group (n = 30) and non-dialysis group (n = 30). All the selected patients were in accordance with the definition and staging of CKD by K/DOQI in 2002. The duration of hemodialysis was between 6 months and 2 years. The selected patients had no recent history of pulmonary infection and no primary thyroid disease. No history of malignant tumor, general situation can. In addition, 30 healthy persons in the physical examination center of Qinghai University affiliated Hospital matched with the experimental group were selected as the control group, and all of them had no heart lung disease and normal liver and kidney function. The age and sex composition of each group had no statistical significance and was comparable. The statistical analysis was carried out by using SPSS17.0 software package. The measurement data were expressed as x + s, single factor analysis of variance and linear correlation analysis were adopted among different groups. The test standard a0.05 was statistically significant (P < 0. 05). Results: 1. There were significant differences in serum thyroid hormone and ALB,CRP between the experimental group and the control group (P < 0. 05), which indicated that the serum thyroid hormone level and serum ALB level in the experimental group were lower than those in the control group. The level of serum CRP was higher than that of control group. There was significant difference between dialysis group and non-dialysis group (P < 0. 05). 2. Correlation analysis of serum thyroid hormone and ALB in experimental group was positive (P < 0. 05). There was a negative correlation with serum CRP (P < 0. 05). Conclusions: 1. The levels of thyroid hormone, serum ALB and serum CRP in patients with end-stage nephropathy were significantly lower than those in healthy subjects, while the levels of thyroid hormones in dialysis patients were significantly higher than those in healthy subjects. Serum ALB level was significantly higher than that in non-dialysis patients, and serum CRP level was significantly lower than that in non-dialysis patients. These results suggest that there are thyroid functional changes and microinflammatory symptoms caused by non-thyroid diseases in patients with end-stage nephropathy. These symptoms were significantly alleviated after dialysis treatment than in non-dialysis patients. The improvement of general condition after dialysis may be related to the reduction of water load, the effective clearance of inflammatory factors, and the clearance of toxins. Therefore, when the patients with chronic kidney disease develop to the end stage, this study can provide a certain clinical reference for us to take early intervention measures of hemodialysis to reduce the occurrence of the above complications. In patients with end-stage nephropathy, serum thyroid hormone was negatively correlated with serum CRP, and positively correlated with serum ALB. It can be concluded that the changes of thyroid function of the patients are related to the severity of microinflammation, therefore, the clinical intervention measures can be taken actively for the dialysis population. For example, the application of highly biocompatible dialysis membrane can reduce the occurrence of microinflammation or supplement albumin, so as to prevent the decrease of thyroid hormone which may lead to the decrease of thyroid hormone, which may lead to the occurrence and aggravation of related symptoms.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692
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