Shirota T, Shinoda T, Yamada T, Aizawa T
Department of Gerontology, Endocrinology, and Metabolism, School of Medicine, Shinshu University, Matsumoto, Japan.
Metabolism. 1992 Apr;41(4):402-5. doi: 10.1016/0026-0495(92)90075-l.
In 77 untreated patients (16 males and 61 females, aged 12 to 65 years) with hyperthyroid Graves' disease, and in 107 control subjects (36 males and 71 females, aged 13 to 78 years), blood urea nitrogen (BUN), serum creatinine (Scr) levels, and BUN to Scr ratios (BUN/Scr) were determined. In 53 patients, the determinations were performed before treatment and after restoration of euthyroidism by treatment with an antithyroid drug. In addition, in seven untreated patients and seven normal subjects, renal clearances of creatinine (Ccr), urea nitrogen (Cun), inulin (Cin), and p-aminohippurate (CPAH) were also determined. The distal tubule delivery of chloride (DTD) and the distal fractional chloride reabsorption (DFCR) were also measured in these subjects: DTD = (CH2O + Ccl)/Cin x 100, and DFCR = CH20/(H20 + Ccl) x 100, where CH20 and Ccl stand for clearances of H2O and chloride, respectively. BUN was significantly elevated, while Scr was significantly depressed, in untreated patients with hyperthyroid Graves' disease. Accordingly, the BUN/Scr was markedly elevated. Restoration of euthyroidism accompanied the normalization of all these abnormalities. Ccr and Cun were significantly elevated, but Cin (glomerular filtration rate [GFR]) was slightly, but insignificantly, elevated in the patients. As a result, the ratios Ccr/Cin and Cun/Cin were significantly greater in the patients than in controls (Ccr/Cin, 1.42 v 1.00; Cun/Cin, 0.92 v 0.68). The amounts of urinary creatinine and urea nitrogen (UN) excretion were decreased and increased, respectively, and DTD was significantly depressed, but DFCR was unchanged in the patients. We conclude that BUN is elevated, Scr is depressed, and the BUN/Scr is increased in hyperthyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)
在77例未经治疗的甲状腺功能亢进型格雷夫斯病患者（16例男性和61例女性，年龄12至65岁）以及107名对照者（36例男性和71例女性，年龄13至78岁）中，测定了血尿素氮（BUN）、血清肌酐（Scr）水平以及BUN与Scr的比值（BUN/Scr）。在53例患者中，于治疗前以及使用抗甲状腺药物治疗恢复甲状腺功能正常后进行了测定。此外，在7例未经治疗的患者和7名正常受试者中，还测定了肌酐清除率（Ccr）、尿素氮清除率（Cun）、菊粉清除率（Cin）和对氨基马尿酸清除率（CPAH）。在这些受试者中还测量了远端小管氯化物输送量（DTD）和远端氯化物分数重吸收率（DFCR）：DTD = (CH2O + Ccl)/Cin × 100，DFCR = CH20/(H20 + Ccl) × 100，其中CH20和Ccl分别代表水和氯化物的清除率。未经治疗的甲状腺功能亢进型格雷夫斯病患者的BUN显著升高，而Scr显著降低。因此，BUN/Scr明显升高。甲状腺功能恢复正常伴随着所有这些异常情况的正常化。患者的Ccr和Cun显著升高，但Cin（肾小球滤过率[GFR]）略有升高但不显著。结果，患者的Ccr/Cin和Cun/Cin比值显著高于对照组（Ccr/Cin，1.42对1.00；Cun/Cin，0.92对0.68）。患者的尿肌酐和尿素氮（UN）排泄量分别减少和增加，DTD显著降低，但DFCR未改变。我们得出结论，甲状腺功能亢进时BUN升高、Scr降低且BUN/Scr增加。（摘要截短于250字）
