【摘要】 目的:探讨初发Graves病(GD)患者抗甲亢药物治疗前、后肾功能某些指标的变化及意义,从而判断GD肾功能情况,并了解其与甲状腺功能、甲状腺抗体的相关性。方法:采用免疫透射比浊法、放射免疫分析法、肌氨酸氧化酶法、化学发光免疫分析法测定30例初发GD患者治疗前、后尿液β2-微球蛋白(β2-MG)、尿白蛋白/肌酐(Alb/Cr)、内生肌酐清除率(Ccr)、血清肌酐(SCr)、FT3、FT4、TSH及甲状腺抗体TR-Ab,并和30例健康对照组进行比较。结果:(1)治疗前血及尿β2-MG、尿Alb/Cr、Ccr与FT3、FT4明显升高,与治疗缓解后及对照组相比有显著差异(均P<0.05);治疗缓解后与对照组比较差异无统计学意义(P>0.05)。治疗前TSH、肌酐低于治疗缓解后及对照组(P<0.001),治疗缓解后仍低于对照组(P<0.001)。(2)△尿Alb/Cr、△Ccr与log10(治疗后FT3/治疗前FT3)及log10(治疗后FT4/治疗前FT4)成正相关,相关具有显著性,(r=0.587,P<0.001;r=0.616,P<0.001;r=0.611,P<0.01;r=0.666,P<0.001);△SCr与log10(治疗后FT3/治疗前FT3)及log10(治疗后FT4/治疗前FT4)成负相关,相关具有显著性(r=-0.638,P=0.001;r=-0.688,P=0.001)。(3)FT3、FT4与TR-Ab成正相关(rs=0.557,P<0.001;rs=0.606,P<0.001)。结论:GD患者可能存在早期肾损伤,可能与甲状腺激素作用有关;GD早期肾损伤具有一定可逆性。更多还原

【Abstract】 Objective Some renal function indicators which reflect early renal injury were determined in primary GD patients before and after antithyroid drug treatment, then to learn the correlation of these indicators with thyroid hormone and thyroid antibody. Methods The serum and urinary β2-MG, urinary Alb / Cr, endogenous creatinine clearance, serum creatinine, FT3, FT4, TSH, thyroid antibody TR-Ab levels were determined in 30 primary GD patients before and remission after treatment and in 30 cases of healthy controls by Immune transmission turbidity ,Radio immunoassay, Sarcosine oxidase, Chemiluminescence immunoassay and in 30 cases of healthy controls. Results(1) The serum and urinary β2-MG, urinary Alb / Cr, endogenous creatinine clearance, serum creatinine, FT3, FT4 of patients before treatment were significantly higher than the remission group and the control group (P < 0.05); but there was no significant difference between the remission group and the control group. The leves of serum creatinine , TSH of patients before treatment were significantly lower than those of remission group and the control group (P < 0.05, P <0.001). The leves of remission group was significantly lower than the control group (P < 0.05). (2)△Urinary Alb / cr,△endogenous creatinine clearance were positive correlated with the level of log10 (post-treatment FT3 / pre-treatment FT3) and log10 (post-treatment FT4 / pre-treatment FT4) positively, the correlation is significant(r = 0.587, P = 0.001;r = 0.616, P = 0.001; r = 0.611,P = 0.01; r = 0.666, P = 0.001);△The serum creatinine was correlated with the level of log10 (post-treatment FT3 / pre-treatment FT3) and log10 (post-treatment FT4 / pre-treatment FT4) negetively, the correlation is significant(r = -0.638, P < 0.001; r = -0.688, P < 0.001). (3) The levels of FT3 and FT4 were positive correlated with TR-Ab (rs = 0.557, P < 0.001; rs = 0.606, P < 0.001). Conclusion The results showed that GD patients may have early renal injury, which may be correlated with the effect of thyroid hormone. Early renal injury in GD patients may be reversible.更多还原