FUNKCIJA ŠTITASTE ŽLEZDE KOD BOLESNIKA NA HEMODIJALIZI
Sažetak
Cilj. Cilj studije je procena funkcije štitaste žlezde kod bolesnika koji se leče redovnim hemodijalizama i uticaj parametara hemodijalize na funkciju štitaste žlezde.
Metode. Ova klinička studija urađena je na uzorku od 50 bolesnika koji je izabran od ukupnog broja bolesnika koji se leče redovnim hemodijalizama u Centru za nefrologiju i dijalizu KC Kragujevac zaključno sa 31.12.2014.godine. Svi bolesnici su klinički ( anamneza ) i laboratorijski ( standardne laboratorijske analize, hormonski parametri funkcije štitaste žlezde TSH, FT3 i FT4 i parametri o kvalitetu hemodijalize - URR- Urea reduction Ratio i singl-pool indexa Kt/V ) ispitani. U obradi rezultata korišćena je statistička metodologija rada ( deskriptivna, kvantitativna i grafička ).
Rezultati. U strukturi ispitivanih bolesnika srednji nivo hormona FT3 u serumu je bio ispod donje granice referentnih vrednosti, dok je srednji nivo hormona TSH i FT4 bio u granicama referentnih vrednosti. Smanjena funkcija štitaste žlezde je registrovana kod 8% bolesnika.Netiroidna bolest ( Euthyroid Sick Syndrome ) je registrovana kod 52% bolesnika. U ispitivanoj grupi bolesnika uticaj na funkciju štitaste žlezde su ispoljili sledeći faktori: Kt/V kao parametra adekvatnosti hemodijalize, koncentracija RTN ( parathormon ) u serumu < 150 i > 1000 pg/ml, koncentraciji Sa ( kalcijuma ) u serumu <2.24 i > 2.54 mmol/ml. Na funkciju štitaste žlezde nisu ispoljili uticaj sledeći faktori: dužina lečenja hemodijalizom, URR kao parametra adekvatnosti hemodijalize, koncentraciji RO4 i proizvoda solubiliteta u serumu bolesnika, postojanje šećerne bolesti i tip dijalizne membrane.
Zaključak. Završni stadijum bubrežne slabosti i hemodijaliza utiču na funkciju štitaste žlezde na više načina. Smanjena funkcija štitaste žlezde je registrovana kod 8% bolesnika. Netiroidna bolest ( Euthyroid Sick Syndrome ) je registrovana kod 52% bolesnika.
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