CAJ | 학술논문

目的探讨肾移植受者的血清甲状腺激素水平与移植肾功能的关系.方法 57例肾移植受者根据移植后肾功能恢复情况分为移植肾功能恢复延迟(DGF)组(7例)和稳定组(50例).检测两组术前及术后不同时间的血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺素(TSH)和血清肌酐(Scr)水平.另检测30名健康志愿者的4项指标水平,作为正常对照.将稳定组术后第10天甲状腺激素水平与Scr水平进行相关性分析.结果稳定组和DGF组术前血清T3、T4水平低于对照组(P＜0.01),而两组术前TSH水平与对照组相比较,差异无统计学意义(P＞0.05).稳定组与DGF组间术前各指标的差异无统计学意义(P＞0.05).稳定组术后第1天T3较术前下降约30％(P＜0.05),下降幅度大于其他指标,直到术后1周开始上升,术后2周接近正常水平,术后3周时已高于术前(P＜0.01)；T4术后早期降低,10d后呈上升趋势,术后3周才接近术前水平；术后各时间段TSH水平与术前相比较,差异均无统计学意义(P＞0.05)；Scr于术后7d恢复至正常水平.DGF组T3于术后21 d达到正常水平,T4于术后30 d达到术前水平；Scr于术后30 d达到正常水平.术后第10天,稳定组受者血清T3与Scr呈负相关(相关系数=0.546,P＜0.01),T4与Scr呈负相关(相关系数=0.423,P＜0.01).TSH与Scr无相关性.结论 T3、T4水平与移植后肾功能有相关性,要重视肾移植受者术后早期甲状腺功能状态及对受者恢复的影响.
목적 탐토신이식수자적혈청갑상선격소수평여이식신공능적관계.방법 57례신이식수자근거이식후신공능회복정황분위이식신공능회복연지(DGF)조(7례)화은정조(50례).검측량조술전급술후불동시간적혈청삼전갑상선원안산(T3)、갑상선소(T4)、촉갑상선소(TSH)화혈청기항(Scr)수평.령검측30명건강지원자적4항지표수평,작위정상대조.장은정조술후제10천갑상선격소수평여Scr수평진행상관성분석.결과 은정조화DGF조술전혈청T3、T4수평저우대조조(P＜0.01),이량조술전TSH수평여대조조상비교,차이무통계학의의(P＞0.05).은정조여DGF조간술전각지표적차이무통계학의의(P＞0.05).은정조술후제1천T3교술전하강약30％(P＜0.05),하강폭도대우기타지표,직도술후1주개시상승,술후2주접근정상수평,술후3주시이고우술전(P＜0.01)；T4술후조기강저,10d후정상승추세,술후3주재접근술전수평；술후각시간단TSH수평여술전상비교,차이균무통계학의의(P＞0.05)；Scr우술후7d회복지정상수평.DGF조T3우술후21 d체도정상수평,T4우술후30 d체도술전수평；Scr우술후30 d체도정상수평.술후제10천,은정조수자혈청T3여Scr정부상관(상관계수=0.546,P＜0.01),T4여Scr정부상관(상관계수=0.423,P＜0.01).TSH여Scr무상관성.결론 T3、T4수평여이식후신공능유상관성,요중시신이식수자술후조기갑상선공능상태급대수자회복적영향.
Objective Monitoring the thyroid hormone levels in patients before and after renal transplantation to realize the relationship between thyroid hormones and renal function.Methods Fifty-seven patients were subdivided into stabled graft function group (50 cases) and delayed graft function (DGF) group (7 cases).Thirty healthy men served as control group.Serum triiodothyronine (T3),thyroxine (T4),thyroid-stimulating hormone (TSH) and serum creatinine (Scr) were determined respectably before transplantation and on different days after transplantation.Correlations between thyroid hormones and Scr at 10th day after transplantation were analyzed.Results Serum T3 and T4 levels before transplantation in the two groups were significantly lower than those in the control group (P＜0.01).These four parameters levels had no significant difference between stabled graft function group and DGF group (P＞0.05).In stabled graft function group:T3 level was decreased obviously by 30％ in the 1st day after transplantation,which was higher than the others,elevated at the 1st week post-transplantation,reached the normal range.at the 2nd week post-operation,and higher than pre-transplantation (P ＜ 0.01) at 3rd week; T4 revealed a decrease trend after transplantation and was elevated at 10th day post-transplantation,returned to the pre-transplantation level at 3rd week; TSH had slight decrease after operation,and had no significant difference among every period in comparing with pre-transplantation; Scr revealed a decrease trend continuously and returned to the normal level at the 7th day post-transplantation.In DGF group,Hormones levels were obviously decreased as compared with stabled graft function group; T3 reached the normal range at the 3rd week post-transplantation,whereas T4 returned to pre-transplantation levels at the 30th day; TSH had a significant decrease at the 5th day,and began to increase at the 10th day post-operation; Scr retuned to the normal range at the 30th day post-operation.The correlation coefficients between Scr and T3,T4 were 0.546 and 0.423 respectively.Conclusion There is a significant correlation between thyroid hormones and renal function (T3,T4).Monitoring the thyroid hormones,specially T3,can diagnose renal function change.