Adlkofer F, Hain H, Meinhold H, Kraft D, Ramsden D, Herrmann J, Heller W D
Acta Endocrinol (Copenh). 1983 Mar;102(3):367-76. doi: 10.1530/acta.0.1020367.
The thyroid function of 13 patients with proteinuria and normal serum creatinine level (Group 1) and 15 patients with proteinuria and increased creatinine level (Group 2) was investigated. The daily urinary T41- and T3 excretion was much higher in Group 1 patients than in Group 2 patients (37.1 +/- 25.9 nmol T4 vs 17.5 +/- 8.7 nmol T4, 3.3 +/- 1.6 nmol T3 vs 1.1 +/- 0.8 nmol T3, respectively) and correlated in both groups with the protein loss. None of the patients suffered from hypothyroidism as a consequence of this hormone loss. Although the mean serum T4-, T3-, FT4-, FT3-, TBG- and TBPA concentrations in both groups of patients were within the normal range, the urinary hormone loss appeared to influence these values considerably. It was striking that the rT3 concentration in the patients with the highest hormone loss was frequently less than 0.08 nmol/l, the lower limit of detectability. The basal TSH levels in serum of the nephrotic patients were similar to those of normal individuals. The thyroid function of patients with proteinuria accompanied by retention of creatinine due to renal failure was more difficult to assess because different pathological mechanisms may exert their influence on the thyroidal hormone secretion as well as on the peripheral hormone metabolism.
对13例蛋白尿且血清肌酐水平正常的患者（第1组）和15例蛋白尿且肌酐水平升高的患者（第2组）的甲状腺功能进行了研究。第1组患者每日尿T41和T3排泄量远高于第2组患者（分别为37.1±25.9 nmol T4 对17.5±8.7 nmol T4，3.3±1.6 nmol T3对1.1±0.8 nmol T3），且两组中均与蛋白质丢失相关。这些患者均未因这种激素丢失而患甲状腺功能减退症。尽管两组患者的血清T4、T3、FT4、FT3、TBG和TBPA平均浓度均在正常范围内，但尿激素丢失似乎对这些值有相当大的影响。值得注意的是，激素丢失最多的患者中rT3浓度经常低于可检测下限0.08 nmol/l。肾病患者血清中的基础TSH水平与正常个体相似。由于不同的病理机制可能对甲状腺激素分泌以及外周激素代谢产生影响，因此伴有因肾衰竭导致肌酐潴留的蛋白尿患者的甲状腺功能更难评估。
