Muschmov D, Zacharieva B
Z Urol Nephrol. 1982 Apr;75(4):269-74.
The levels of tri-iodothyronine (T3), free T3 index (FT3I), thyroxine (T4), free T4 index (FT4I), thyrothopine (TSH), reverse T3(rT3), T3 resin uptake (T3U) and thyroxine-binding globulin (TBG) were investigated in 30 conservatively treated euthyrodic kidney patients with varying degrees of disturbance to kidney function. The authors found that the phenomena of the so-called "low T3 syndrome" (low T3 and FT3 while T4 is low to normal and FT4 and TSH are normal) appear not only in patients with advanced chronic renal insufficiency but also in patients who are in the 2nd state of chronic renal insufficiency (serum creatinine 4--8 mg%). The incidence and degree of reduced T3 were equal in both groups of patients. It must however be stressed that, in contrast to other chronic diseases with "low T3 syndrome", the low T3 concentrations in kidney patients are not accompanied by a simultaneous increase in the synthesis of rT3. The high levels detected of the quotients T4/T3 and the normal levels of TBG allow the reduced capacity of thyroxine-binding globulin (TBG) to be ruled out as the cause of the low levels of T3.
对30例接受保守治疗的甲状腺功能正常但肾功能有不同程度损害的肾脏疾病患者，检测了其三碘甲状腺原氨酸（T3）、游离T3指数（FT3I）、甲状腺素（T4）、游离T4指数（FT4I）、促甲状腺激素（TSH）、反T3（rT3）、T3树脂摄取率（T3U）及甲状腺素结合球蛋白（TBG）水平。作者发现，所谓的“低T3综合征”现象（T3和FT3降低，而T4降低至正常，FT4和TSH正常）不仅出现在晚期慢性肾功能不全患者中，也出现在慢性肾功能不全第二期（血清肌酐4-8mg%）的患者中。两组患者T3降低的发生率和程度相当。然而必须强调的是，与其他伴有“低T3综合征”的慢性疾病不同，肾脏疾病患者T3浓度降低时，rT3的合成并未同时增加。所检测到的T4/T3比值升高以及TBG水平正常，可排除甲状腺素结合球蛋白（TBG）结合能力降低是T3水平降低的原因。
