Soffer O, Pelet D, Segal S, Bar-Khayim Y
Isr J Med Sci. 1979 Oct;15(10):836-9.
The relevance of the biochemical evidence of hypothyroidism in patients on regular hemodialysis is debatable. Several indexes of thyroid function were assessed in 46 patients undergoing chronic hemodialysis for 2 to 45 months. Low serum levels of thyroxine were found in 69.5% of the patients studied and of triiodothyronine (T3) in 46.5%. Low values of T3-Sephadex binding were noted in 17.3%, of free thyroxine index (FTI) in 26.3% and of radioiodine uptake in 19.3% of the patients; 13.0% had high levels of thyroid-stimulating hormone (TSH). The overall incidence of hypothyroidism, based on FTI and TSH, was 34.8%. We concluded that the diagnosis of hypothyroidism should be based on FTI and TSH levels, and that chronically hemodialyzed patients tend to exhibit biochemical rather than clinical hypothyroidism.
常规血液透析患者甲状腺功能减退的生化证据的相关性存在争议。对46例接受慢性血液透析2至45个月的患者的几项甲状腺功能指标进行了评估。在研究的患者中,69.5%的患者血清甲状腺素水平低,46.5%的患者血清三碘甲状腺原氨酸(T3)水平低。17.3%的患者T3 - 葡聚糖凝胶结合值低,26.3%的患者游离甲状腺素指数(FTI)低,19.3%的患者放射性碘摄取率低;13.0%的患者促甲状腺激素(TSH)水平高。基于FTI和TSH,甲状腺功能减退的总体发生率为34.8%。我们得出结论,甲状腺功能减退的诊断应基于FTI和TSH水平,并且长期接受血液透析的患者倾向于表现出生化而非临床甲状腺功能减退。