维持性血液透析患者甲状腺功能、同型半胱氨酸与心血管病变的关系

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Abstract Objective To explore the relationships between thyroid function indexes and homocysteine (Hcy) levels on one hand and cardiac function and carotid artery lesions on the other hand in patients undergoing maintenance hemodialysis (MHD).Methods Seventy patients who underwent MHD in the hospital between January 2017 and December 2018 were enrolled, who had been undergoing dialysis for more than three months. Before dialysis, all the patients were tested for blood routine, glycosylated hemoglobin, blood lipids, calcium, phosphorus, thyroid function indexes [free triiodothyronine (FT₃), free thyroxine (FT₄), thyroid stimulating hormone (TSH)] and serum Hcy levels. Ultrasound examination was conducted for carotid artery lesions. Echocardiograms were used to determine cardiac function indexes.Results Among the 70 patients undergoing MHD, there were 31 cases with thyroid dysfunction that accounted for 44.29%, 51 cases (72.86%) with serum Hcy levels higher than the normal value, 39 cases (55.71%) with left ventricular hypertrophy, and 28 cases (40.00%) with carotid atherosclerosis. Multivariate Logistic regression analysis showed that elevated FT₃ and decreased Hcy were independent risk factors for left ventricular hypertrophy in patients undergoing MHD (P<0.05). The increase of LDL-C, decrease of FT₃ and elevation of Hcy were independent risk factors for carotid atherosclerosis (P<0.05).Conclusions MHD patients are usually accompanied by abnormal thyroid function and serum Hcy levels, such as the decrease of FT₃ and increase of Hcy levels, which are closely related to left ventricular hypertrophy and carotid atherosclerosis.

Key words： maintenance hemodialysis thyroid function homocysteine left ventricular hypertrophy carotid atherosclerosis

Received: 10 September 2019

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2020/V31/I1/55

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