【摘要】 目的探讨慢性肾脏病(CKD)患者亚临床甲状腺功能减退症(SCH)的相关因素。方法收集并选取2016年2月至2017年10月在临沂市中心医院肾内科住院CKD患者111例为研究对象,健康体检中心63例无CKD普通人群为对照组,对2组均收集临床资料、血清生化指标,并检测甲状腺功能,包括血清游离T3(FT3)、游离T4(FT4)、促甲状腺素(TSH),计算估计肾小球滤过率(eGFR);对SCH相关因素进行单因素和多因素logistic回归分析。结果 111例CKD组患者SCH患病率为22.5%,63例对照组SCH患病率为12.7%,CKD组患病率更高,差异具有统计学意义(P<0.05)。单因素分析显示,CKD患者中,SCH组中收缩压、血糖更高,eGFR指标更低,且差异均具有统计学意义(P<0.05)。多因素logistic回归分析显示,在校正了其他相关因素后,收缩压(OR值1.035,P<0.05)及eGFR(OR值0.951,P<0.01)仍是SCH的相关因素。收缩压每增加1mmHg,其风险增加3.4%,eGFR每下降1 ml/min/1.73m~2,其风险升高4.9%。结论 CKD患者SCH患病率较普通人群更高,收缩压、eGFR是其独立危险因素。更多还原

【Abstract】 Objective To investigate the relative factors of subclinical hypothyroidism(SCH) in patients with chronic kidney disease(CKD). Methods Collected and selected 111 patients with CKD from February 2016 to October 2017 in the department of nephrology, Linyi central hospital,63 healthy people without CKD were selected as the control group,the clinical data, serum biochemical parameters and thyroid function were collected in the 2 groups,and the thyroid function was checked, these include serum free T3(FT3), free T4(FT4) and thyroid stimulating hormone(TSH),the estimated glomerular filtration rate(eGFR) was estimated;Single factor and multiple factor logistic regression analysis was performed on SCH related factors. Results The prevalence of SCH was 22.5% in the 111 CKD patients,in 63 cases of the control group, the prevalence of SCH was 12.7%, the prevalence of CKD group was higher, and the difference was statistically significant(P< 0.05). Single factor analysis shows that,in patients with CKD, systolic blood pressure and blood glucose were higher and eGFR index was lower in group SCH, and the difference was statistically significant(P<0.05). Multiple factor logistic regression analysis showed that,after adjusting for other related factors, systolic blood pressure(OR value 1.035, P < 0.05) and eGFR(OR 0.951, P < 0.01) were still related factors of SCH. When the systolic pressure increased by 1 mmHg, the risk increased by 3.4%,eGFR decreased by 1 ml/min/1.73 m~2, and its risk increased by 4.9%. Conclusion The prevalence of SCH in CKD patients is higher than that in the general population,systolic pressure and eGFR are the independent risk factors.更多还原