The Changes Of Thyroid Function In Patients With Primary Nephrotic Syndrome And The Relationship With Urinary Protein And Renal Pathologe

Objective To study the changes of thyroid function in patients with primarynephrotic syndrome and the relationship with urinary protein and renal pathology.Methods A retrospective analysis of82cases with primary nephrotic syndromepatients in Zhongshan Hospital Xiamen University (group PNS)，without previous th-yroid diseases were，divided into normal thyroid function group (group NG) and thy-roid dysfunction group (group AG)，according to the levels of thyroid hormones.20normal subjects were choosed as control group (group CG). Thyroid hormone levels、serum lipid、serum albumin、creatinine、urea nitrogen、urinary albumin levels wereexaminated. The correlation between pathological types and thyroid function were ob-served.Results①There are20cases of normal thyroid function and62cases of abn-ormal thyroid function in82cases of PNS. There were10cases of hypothyroidism、2cases of hyperthyroidism、49cases of nonthyroidal illness syndrome、1cases of Has-himoto’s thyroiditis in group AG. Compared with group CG，FT3、FT4significantlydecreased（FT3：3.22±1.55pmol/l VS4.44±0.93pmol/l，FT4：13.08±3.51pmol/l VS19.20±2.77pmol/l）、TSH signifycantly increased（4.09±4.11uIU/l VS2.48±1.06uIU/l）（p＜0.05）in group PNS.②The levels of serum albumin were lower in groupAGthan in group NG（18.28±5.31g/l VS22.87±3.61g/l，p＜0.05)，urinary microalbuminwas higher in group AG than group NG（8873.52±6990.76mg/l VS3167.8±1629.66mg/l，p＜0.05）.③In group AG，FT3、FT4levels were positively correlated withserum albumin（FT3：r=0.301，p＜0.05；FT4：r=0.311，p＜0.05），FT4were negativelycorrelated with urinary microalbumin (r=-0.282，p＜0.05)，but FT3had no correla-tion with urinary microalbumin (r=-0.177，p＞0.05)，TSH were negatively correlated with serum albumin，but positively correlated with microalbumin（p＜0.05）；The levelof TH in group AG had no correlation with serum lipid (p＞0.05).④The constituentratio of different renal pathological types in group NG and in group AG was no obvi-ous different（χ2=2.223，p=0.695＞0.05）.Conclusions①Primary nephrotic syndrome patients are easy to merge withabnormal thyroid function clinically，especially nonthyroidal illness syndrome. Theexamination of thyroid function can help to assess the severity of the disease；②Thereason of PNS patients appeare thyroid dysfunction were not only a protective mecha-nism of the body under disease，but also associated with reducing raw material、hypo-albuminemia、effection of drug、immune injury and so on；③FT3、FT4levels werepositively correlated with serum albumin，but negatively correlated with urinary mi-croalbumin， PNS patients with thyroid dysfunction may have no relations with thetype of renal pathological types.