Clinical Study Of FT₃ And Left Ventricular Hypertrophy In Maintenance Hemodialysis Patients

Objective:To investigate the relationship between serum free triiodothyronine（FT₃）and left ventricular hypertrophy（LVH）in patients with maintenance hemodialysis（MHD）.To provides a theoretical basis for early prevention and treatment of LVH.Methods:A total of seventy-seven patients with MHD were enrolled in our hospital from February 2014 to August 2018.According to the LVH diagnostic criteria,the patients were divided into non-left ventricular hypertrophy group and left ventricular hypertrophy group.Observe the patient’s gender,age,dialysis age,primary disease,mean arterial pressure（MAP）and hemoglobin（Hb）,albumin（ALB）,blood urea nitrogen（BUN）,serum creatinine（Scr）,uric acid（UA）,calcium（Ca）,Phosphorus（P）,total cholesterol（TC）,triglyceride（TG）,Low-density lipoprotein（LDL）,high-density lipoprotein（HDL）,high sensitivity C-reactive protein（hs-CRP）,Urea clearance index（Kt/V）,parathyroid hormone（PTH）,N terminal pro B tybe natriuretide（NT-proBNP）,free triiodothyronine（FT₃）,free tetraiodothyronine（FT₄）,Thyroid stimulating hormone（TSH）,thyroglobulin antibodies（A-TG）,thyroperoxidase antibodies（A-TPO）.Cardiac color Doppler ultrasound was used to detect interventricular septal thickness（IVST）,left ventricular posterior wall thickness（LVPWT）,left ventricular end diastolic diameter（LVEDd）,and ejection fraction（EF）.The two groups of general data and clinical data were compared;the correlation between left ventricular mass index（LVMI）and each index was analyzed;multiple linear regression analysis was used to analyze the risk factors of LVH.Results:（1）A total of seventy-seven cases were included and forty-three cases were in the left ventricular hypertrophy group,including twenty-two males and twenty-one females.The incidence of LVH was 55.8%.Thirty-four cases were in the non-left ventricular hypertrophy group,including twenty-four males and ten females.Twenty-nine cases is low FT₃,the incidence of low FT₃ was 37.7%.（2）Comparing the general data and clinical data between the groups:FT₃,Hb,ALB,EF in the left ventricular hypertrophy group were lower than those in the non-left ventricular hypertrophy group（P<0.05）;hs-CRP,MAP,NT-proBNP were higher than non-left ventricle Hypertrophic group（P<0.05）.There were no significant differences in gender,age,dialysis age,BUN,Scr,UA,Ca,P,TC,TG,LDL,HDL,Kt/V,PTH,FT₄,TSH,A-TPO and A-TG（P>0.05）.（3）Correlation analysis between LVMI and various indicators:LVMI was negatively correlated with FT₃,Hb and EF（P<0.05）.LVMI was positively correlated with hs-CRP,MAP and NT-proBNP（P<0.05）.（4）Linear regression analysis of LVMI influencing factors:LVMI was the dependent variable and each factor was multivariate.Perform multiple linear regression analysis.It showed that FT₃,Hb and hs-CRP were risk factors for LVH.Conclusion:Low FT₃ is a risk factor for LVH in patients with MHD.It is suggested that MHD patients need to detect FT₃ levels in clinical work,which provides a theoretical basis for early prevention and treatment of LVH.