Fernández-Reyes M J, Diez J J, Collado A, Iglesias P, Bajo M A, Estrada P, Del Peso G, Heras M, Molina A, Selgas R
Servicio de Nefrología H General Segovia, Segovia, Madrid.
Clin Nephrol. 2010 Mar;73(3):238-40. doi: 10.5414/cnp73238.
Low serum free triiodothyronine (FT3) concentrations have been reported in a high percentage of chronic renal failure patients and have been considered as an independent predictor of mortality in dialysis patients.
Our aim has been to evaluate the prognostic value of FT3 levels for long-term mortality in stable hemodialysis patients surviving at least 12 months.
We retrospectively analyzed 89 stable hemodialysis patients (50 males; mean age 67.9 +/- 11.8 years). All patients had a baseline clinical and analytical evaluation. We analyzed the relationship between baseline FT3 and mortality by means of survival analysis (Kaplan-Meier) and Cox regression analysis.
Mean values of thyroid function test were: thyrotropin (TSH) 2.02 +/- 1.5 microU/ml, free thyroxine (FT4) 1.26 +/- 0.23 ng/dl, and FT3 2.7 +/- 0.4 pg/ml. During a median follow-up time of 33.6 +/- 14.9 (12 - 62) months, 41 patients died. FT3 was similar in patients who died or survived (2.6 +/- 0.5 vs. 2.7 +/- 0.4 pg/ml ns). Kaplan-Meier analysis did not show significant differences in mean survival according to tertiles of FT3. In multivariate Cox regression analysis, FT3 was not a predictor of mortality (RR 0,001; 95% CI; 0.000 to 1.73).
These data suggest that low FT3 levels are not predictive for mortality in a subgroup of stable HD patients who could survive more than 12 months.
据报道，高比例的慢性肾衰竭患者血清游离三碘甲状腺原氨酸（FT3）浓度较低，且被认为是透析患者死亡率的独立预测指标。
我们的目的是评估FT3水平对至少存活12个月的稳定血液透析患者长期死亡率的预后价值。
我们回顾性分析了89例稳定血液透析患者（50例男性；平均年龄67.9±11.8岁）。所有患者均进行了基线临床和分析评估。我们通过生存分析（Kaplan-Meier）和Cox回归分析来分析基线FT3与死亡率之间的关系。
甲状腺功能测试的平均值为：促甲状腺激素（TSH）2.02±1.5微单位/毫升，游离甲状腺素（FT4）1.26±0.23纳克/分升，FT3 2.7±0.4皮克/毫升。在中位随访时间33.6±14.9（12 - 62）个月期间，41例患者死亡。死亡患者和存活患者的FT3相似（2.6±0.5与2.7±0.4皮克/毫升，无显著性差异）。根据FT3三分位数的Kaplan-Meier分析未显示平均生存期有显著差异。在多变量Cox回归分析中，FT3不是死亡率的预测指标（风险比0.001；95%置信区间；0.000至1.73）。
这些数据表明，低FT3水平对能够存活超过12个月的稳定血液透析患者亚组的死亡率没有预测价值。
