首页|肾病综合征合并甲状腺功能异常患者的病理特点

肾病综合征合并甲状腺功能异常患者的病理特点

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目的:肾病综合征(nephrotic syndrome,NS)是一种常见的肾小球疾病,其病理类型繁多,在临床实践中,NS容易发生甲状腺功能异常.本研究旨在分析NS合并甲状腺功能异常患者的病理特点.方法:选取2015年1月至2021年12月于宜昌市中心人民医院肾内科住院且已行肾活检的NS患者499例.根据纳入患者的甲状腺功能检查结果,分为甲状腺功能正常组(n=187)和甲状腺功能异常组(n=312);根据病因分为原发性肾病综合征(primary nephrotic syndrome,PNS)组和继发性肾病综合征(secondary nephrotic syndrome,SNS)组.收集患者相关临床数据,分析NS患者各项临床指标与甲状腺功能之间的关系,以及肾脏病理类型与甲状腺功能异常之间的关系、PNS和SNS与甲状腺功能之间的关系.结果:1)在499例NS患者中,甲状腺功能正常组和甲状腺功能异常组患者的性别、住院天数、24 h尿蛋白定量(24-hour urinary protein excretion,24 h-UTP)、白蛋白(albumin,Alb)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)差异均有统计学意义(均P<0.05).2)甲状腺功能异常组中膜性肾病最常见(P<0.05),微小病变性肾病发生甲状腺功能异常的概率最高(P<0.05).PNS组中以亚临床甲状腺功能减退最常见(39.19%),SNS组中以正常甲状腺功能病态综合征最常见(47.78%),差异均有统计学意义(均P<0.05).结论:NS患者不同的肾脏病理类型发生甲状腺功能异常的比例不一致,PNS和SNS发生甲状腺功能异常的临床表型也不一样.
Pathological characteristics of nephrotic syndrome patients with thyroid dysfunction
Objective:Nephrotic syndrome(NS)is a common glomerular disease with various pathological types and is often associated with thyroid dysfunction in clinical practice.This study aims to analyze the pathological characteristics of NS patients with thyroid dysfunction.Methods:A total of 499 NS patients who were admitted to the Department of Nephrology at Yichang Central People's Hospital from January 2015 to December 2021 and underwent renal biopsy were selected.Based on thyroid function test results,the patients were divided into a normal thyroid function group(n=187)and a thyroid dysfunction group(n=312);based on etiology,they were categorized into a primary nephrotic syndrome(PNS)group and a secondary nephrotic syndrome(SNS)group.Relevant clinical data were collected to analyze the relationships between the clinical indicators and thyroid function,the renal pathology types and thyroid dysfunction,and differences in thyroid function between PNS and SNS.Results:1)In the 499 NS patients,there were significant differences in gender,hospital stay,24-hour urinary protein excretion(24 h-UTP),albumin(Alb),free triiodothyronine(FT3),and free thyroxine(FT4)between the normal group and the thyroid dysfunction group(all P<0.05);2)the membranous nephropathy was the most common pathological type in the thyroid dysfunction group(P<0.05),with minimal change disease(MCD)showing the highest probability of thyroid dysfunction(P<0.05).Subclinical hypothyroidism was most prevalent in the PNS group(39.19%),while the euthyroid sick syndrome was most common in the SNS group(47.78%),with both showing significant differences(both P<0.05).Conclusion:The proportion of thyroid dysfunction varies with different renal pathological types in the NS patients,and there is difference in the clinical phenotypes of thyroid dysfunction between PNS and SNS.

nephrotic syndromehypothyroidismeuthyroid sick syndromepathological type

李玥、李轩维、马聪媛、许佳美、张萌、刘云涛、朱平

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三峡大学第一临床医学院/宜昌市中心人民医院肾内科/三峡大学肾脏病研究所,湖北 宜昌 443003

三峡大学第二临床医学院/三峡大学附属仁和医院内分泌科,湖北 宜昌 443001

三峡大学风湿免疫疾病研究所,湖北 宜昌 443003

肾病综合征 甲状腺功能减退 正常甲状腺功能病态综合征 病理类型

2024

临床与病理杂志
中南大学

临床与病理杂志

CSTPCD
影响因子:0.559
ISSN:1673-2588
年,卷(期):2024.44(8)