Savdie E, Stewart J H, Mahony J F, Hayes J M, Lazarus L, Simons L A
Clin Nephrol. 1978 Feb;9(2):68-72.
In vitro thyroid function tests were performed in three groups of patients with chronic renal failure who were receiving, on average, 15, 18 and 27 hours of maintenance hemodialysis per week. Total thyroxine levels were low and total triiodothyronine levels low to normal in those receiving the least dialysis (15 hours), and were significantly higher in those receiving longer dialysis. Free thyroxine levels, as measured by the effective thyroxine ratio, were normal and similar in all three groups, as were serum thyrotrophin levels. All patients were clinically euthyroid. As total hormone levels showed a significant inverse relationship to both urea and creatinine, this study suggests that there is a dialyzable metabolite retained in uremia which competes with thyroid hormones for protein-binding sites.
对三组平均每周接受15、18和27小时维持性血液透析的慢性肾衰竭患者进行了体外甲状腺功能测试。透析时间最短（15小时）的患者总甲状腺素水平较低，总三碘甲状腺原氨酸水平低至正常，而透析时间较长的患者这些指标则显著更高。通过有效甲状腺素比率测定的游离甲状腺素水平在所有三组中均正常且相似，血清促甲状腺激素水平也是如此。所有患者临床甲状腺功能正常。由于总激素水平与尿素和肌酐均呈显著负相关，本研究表明尿毒症中存在一种可透析的代谢产物，它与甲状腺激素竞争蛋白质结合位点。
