CAJ | 학술논문

目的：探讨2型糖尿病肾病（DN ）严重程度与甲状腺功能之间的关系。方法选择住院2型糖尿病肾病患者120例，其中，DN Ⅲ期、Ⅳ期、Ⅴ期各40例，另选40例NDN患者作为对照（NDN）。比较各组血浆白蛋白、血红蛋白、血钾、甲状腺功能，并进行相关性分析。结果Ⅲ、Ⅳ和Ⅴ期患者血浆白蛋白分别为（41．3±3．6）g／L、（30．5±4．8）g／L和（28．3±5．9）g／L，均低于NDN组（F＝11．36，P＜0.05）；Ⅲ、Ⅳ和Ⅴ期患者24 h尿蛋白分别为（0．48±0．29）g、（1．86±0．54）g 和（1．69±0．67）g，均高于 NDN 组（F＝7.12，P＜0.05）；Ⅲ、Ⅳ和Ⅴ期患者三碘甲腺原氨酸（T3）分别为（0．98±0．38）nmol／L、（0．75±0．41）nmol／L和（0.60±0．28）nmol／L，均低于 NDN 组（F ＝7．64，P ＜0．05）；Ⅲ、Ⅳ和Ⅴ期患者甲状腺素（T4）分别为（6．06± 1．76）nmol／L、（5．31±1．98）nmol／L和（4．65±1．87）nmol／L，均低于NDN组（F＝6．83，P＜0.05）；Ⅲ、Ⅳ和Ⅴ期患者游离型三碘甲腺原氨酸（FT3）分别为（4．37±2．12）pmol／L、（3．33±2．30）pmol／L 和（2．91± 1．82）pmol／L，均低于NDN组，差异有统计学意义（F＝7．14，P＜0．05）；等级相关性分析结果提示，FT3是DN严重程度的独立预测因子。结论 DN患者存在不同程度甲状腺功能异常，测定甲状腺激素水平，有助于了解糖尿病肾病病情。
목적：탐토2형당뇨병신병（DN ）엄중정도여갑상선공능지간적관계。방법선택주원2형당뇨병신병환자120례，기중，DN Ⅲ기、Ⅳ기、Ⅴ기각40례，령선40례NDN환자작위대조（NDN）。비교각조혈장백단백、혈홍단백、혈갑、갑상선공능，병진행상관성분석。결과Ⅲ、Ⅳ화Ⅴ기환자혈장백단백분별위（41．3±3．6）g／L、（30．5±4．8）g／L화（28．3±5．9）g／L，균저우NDN조（F＝11．36，P＜0.05）；Ⅲ、Ⅳ화Ⅴ기환자24 h뇨단백분별위（0．48±0．29）g、（1．86±0．54）g 화（1．69±0．67）g，균고우 NDN 조（F＝7.12，P＜0.05）；Ⅲ、Ⅳ화Ⅴ기환자삼전갑선원안산（T3）분별위（0．98±0．38）nmol／L、（0．75±0．41）nmol／L화（0.60±0．28）nmol／L，균저우 NDN 조（F ＝7．64，P ＜0．05）；Ⅲ、Ⅳ화Ⅴ기환자갑상선소（T4）분별위（6．06± 1．76）nmol／L、（5．31±1．98）nmol／L화（4．65±1．87）nmol／L，균저우NDN조（F＝6．83，P＜0.05）；Ⅲ、Ⅳ화Ⅴ기환자유리형삼전갑선원안산（FT3）분별위（4．37±2．12）pmol／L、（3．33±2．30）pmol／L 화（2．91± 1．82）pmol／L，균저우NDN조，차이유통계학의의（F＝7．14，P＜0．05）；등급상관성분석결과제시，FT3시DN엄중정도적독립예측인자。결론 DN환자존재불동정도갑상선공능이상，측정갑상선격소수평，유조우료해당뇨병신병병정。
Objective To analyze the relationship between thyroid function and grades of diabetic nephropa-thy (DN).Methods One hundred and twenty patients with definite DN were classified into the four groups,and forty patients with non-DN diabetic was NDN group.Their serum albumin,blood hemoglobin,serum potassium,functional parameters of thyroid and dependability to DN were analyzed.Results The plasma albumin ofⅢ,Ⅳ and Ⅴ group were (41.3 ±3.6)g/L,(30.5 ±4.8)g/L and (28.3 ±5.9)g/L,which were lower than those of NDN group (F=11.36,P<0.05).24h urine protein ofⅢ,Ⅳ and Ⅴ were (0.48 ±0.29)g,(1.86 ±0.54)g and (1.69 ±0.67)g, which were higher than those of group NDN (F=7.12,P<0.05).Triiodothyronine(T3)ofⅢ,ⅣandⅤgroup were (0.98 ±0.38)nmol/L,(0.75 ±0.41)nmol/L and (0.60 ±0.28)nmol/L,which were lower than those of NDN group (F=7.64,P<0.05).Tetraiodothyronine(T4)of III,IV and V group were (6.06 ±1.76)nmol/L,(5.31 ±1.98)nmol/L and (4.65 ±1.87)nmol/L,which were lower than those of NDN group (F=6.83,P<0.05 ).Free Triiodothyronine (FT3)ofⅢ,Ⅳ and Ⅴ group were (4.37 ±2.12)pmol/L,(3.33 ±2.30)pmol/L and (2.91 ±1.82)pmol/L, which were lower than those of NDN group (F=7.14,P<0.05 ).Correlation analysis indicated that FT3 was an independent predictor for the severity of diabetic nephropathy.Conclusion In the patients with DN Ⅳ and Ⅴ,DN has attained a very severe status and the treatment of DN should be intensive.