Hatron P Y, Wemeau J L, Guillemin R, Raviart B, Vanhille P, Devulder B
Rev Med Interne. 1984 Mar;5(1):35-42. doi: 10.1016/s0248-8663(84)80076-4.
Serum Total Thyroxine (T4), Triiodothyronine (T3), Free Thyroxine (FT4), Free Triiodothyronine (FT3) Reverse Triiodothyronine and T3 Resin Uptake (T3RU) as well as basal and post stimulating TSH were measured in twenty clinically euthyroid patients with the nephrotic syndrome. In comparison with control values, our patients showed (1) significantly lowered mean serum TBG levels (p less than 0,05) (2) unmodified mean serum T3, FT3 and rT3 values (3) significantly lowered mean serum T4 and FT4 levels (p less than 0,001 and p = 0,027 respectively) (4) significantly higher mean basal TSH, and increased TSH response to TRH. We found a significant correlation between proteinemia and T4 or FT4 (p less than 0,001; p less than 0,01 respectively). In summary, our study: Shows that the low Total T4 observed in the Nephrotic Syndrome is not only due to a decreased protein bound T4, but also to a decreased FT4; And brings evidence for mild hypothyroidism in nephrotic patients.
对20例临床甲状腺功能正常的肾病综合征患者测定了血清总甲状腺素（T4）、三碘甲状腺原氨酸（T3）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、反三碘甲状腺原氨酸及T3树脂摄取率（T3RU），以及基础和促甲状腺激素释放激素（TRH）刺激后的促甲状腺激素（TSH）。与对照值相比，我们的患者表现出：（1）血清甲状腺素结合球蛋白（TBG）平均水平显著降低（p<0.05）；（2）血清T3、FT3和反T3平均水平未改变；（3）血清T4和FT4平均水平显著降低（分别为p<0.001和p=0.027）；（4）基础TSH平均水平显著升高，且TSH对TRH的反应增强。我们发现蛋白尿与T4或FT4之间存在显著相关性（分别为p<0.001；p<0.01）。总之，我们的研究表明：肾病综合征中观察到的总T4降低不仅是由于蛋白结合T4减少，也是由于FT4降低；并且为肾病患者存在轻度甲状腺功能减退提供了证据。
