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The background chronic kidney disease (chronic kidney disease, CKD) is a common chronic diseases. In recent years, a number of studies have shown that patients with end-stage renal disease thyroid hormone levels and metabolic abnormalities occur. Currently few studies on the functional status of the maintenance in patients with peritoneal dialysis (CAPD) thyroxine, in particular the lack of investigation and analysis of the CAPD patients with thyroid function and TCM syndromes type of relationship. Objective 1 explore CAPD patients with thyroid function distribution and its related factors; explore the relationship and the mechanism of CAPD patients with low thyroxine state with poor prognosis of clinical; explore CAPD patients with thyroid functional status and TCM this deficiency climate The relationship between long-term peritoneal dialysis patients for clinical application of traditional Chinese medicine against abnormal thyroid function and improve clinical symptoms, improve quality of life provide a theoretical basis. Cross-sectional survey on 3 April 2009 in Peking University Third Hospital, Department of Nephrology, to accept continuous ambulatory peritoneal dialysis (CAPD) patients. Maintenance peritoneal dialysis cases are designed to review information collection form, Peking University Third Hospital dialysis center through access to electronic medical records system, and the original medical records, collect patient demographic data, syndrome type, blood chemistry and thyroid hormone series, nutritional status inflammatory state, atherosclerosis and dialysis adequacy and other indicators; collect patients with complications, and death information by looking for the original medical records and dialysis follow-up record. By Cox regression model to explore the relationship between the low thyroxine state with poor prognosis of clinical, mean comparison and multivariate analysis and other statistical methods to explore the relationship of the liver and kidney syndrome and FT3 levels. 1, a total of 131 cases included in the CAPD patients, male 71 cases (54.2%), average age (60.6 ± 15.9) years, mean dialysis age (25.2 ± 17.7) months, all patients the FT3 in general are a few levels (2.51 ± 0.39 ) pg / ml, thyroid function was normal in 80 cases (61.07%), low T3 syndrome in 38 cases (29.01%), 10 cases of subclinical hypothyroidism, subclinical hyperthyroidism, hypothyroidism. The correlation analysis showed that serum FT3 and patient age, dialysis adequacy, malnutrition (SGA, serum albumin), inflammatory state (CRP), the arteriosclerosis the situation (PWV) showed significant correlation with gender, primary disease and The hyperlipidemia no significant correlation. 2, based on 94 cases of thyroid stimulating hormone (TSH) lt; 20uIU/mL CAPD patients with thyroid function distribution, divided into three groups, normal thyroid function group (63 cases), low T3 syndrome group (n = 24), subclinical hypothyroidism group (n = 7). Low T3 syndrome average age, serum albumin below the normal thyroid function group, PWV was significantly higher than the normal thyroid function group were statistically significant, P lt; 0.05; subclinical hypothyroidism SGA of value, 1gCRP with significant differences in thyroid function normal group, P lt; 0.05. Pearson and Spearman correlation analysis showed FT3 age, dialysis adequacy, SGA, albumin, 1gCRP the existence of a significant correlation, P lt; 0.01; FT3 and PWV was negatively related (r = -0.199, P = 0.054), close to statistically significant. Single-factor analysis of variance results are shown the MIA syndrome group FT3 value significantly lower than other non-MIA syndrome group, P lt; 0.0l. Cox regression model, after the correct gender, diabetes, dialysis age and dialysis adequacy factors, higher age of 1 year complications at higher risk (β = 0.952, P = 0.018), low thyroid function exists at the same time (low T3 or subclinical hypothyroidism), malnutrition, inflammation, arterial atherosclerotic any of the above three factors, the risk of complications was significantly higher (β3 = 14.803, P3 = 0.004; β4 = 32.702, P4 = 0.002 ). 3, CAPD patients were divided into 89 cases of normal thyroid-stimulating hormone (TSH) liver and kidney syndrome group (19 cases), non-Yin Deficiency group (70 cases), results showed that the liver and kidney certificate the group TT3.TT4 with FT3 were significantly lower than non-Yin Deficiency group (TT3, 0.96 ± 0.23ug/mL vs 1.13 ± 0.22ug/mL, P = 0.006; TT4, 7.59 ± 1.69ug/mL vs 8.65 ± 1.55ug/mL, P = 0.017 ; FT3, 2.35 ± 0.35 pg / mL vs 2.57 ± 0.33 pg / mL, P = 0.014); multivariate analysis results are shown in the correction of gender, age, diabetes, dialysis age, liver and kidney, serum albumin, C-reactive protein and Kt / V (remnant kidney) FT3 independent factors (R2 = 0.396, P = 0.000). Conclusion 1, low thyroid hormone levels in CAPD patients mainly to blood FT3 decline; 2, low of thyroxine status and CAPD patients are malnourished - inflammation - atherosclerosis syndrome is closely related to the; 3, associated with hypothyroidism (low CAPD patients with T3 or subclinical hypothyroidism), malnutrition, inflammation, atherosclerosis in any of the three factors, the risk of complications was significantly higher, and the highest risk of the complications of the coexistence of the four factors . 4, of TCM this deficiency climate type CAPD patients whose thyroid function is different from the liver and kidney certificate is an independent risk factor led to reduced maintenance dialysis patients FT3.
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