不同程度肝硬变患者甲状腺素、性激素及促性腺激素的变化  

The change of thyroid hormones, sex hormones and gonadotrophin in different degrees of the cirrhosis patients

作　　者：邹红[1] 刘玉兰[1] 张永利[2] 孙思政 

机构地区：[1]北京医科大学人民医院消化科,邮政编码100044 [2]内蒙古包头市第四医院内科 [3]河北省怀来县医院内科

出　　处：《北京医学》1999年第2期87-90,共4页Beijing Medical Journal

摘　　要：检测７７例男性肝硬变患者（肝硬变组）和３４例健康男性（对照组）血清甲状腺激素和性激素水平，并采用Ｃｈｉｌｄ－Ｐｕｇｈ分级法将上述病例分为Ａ级（２４例）、Ｂ级（３２例）和Ｃ级（２１例）。结果显示，肝硬变组Ｔ３、Ｔ４明显低于对照组；ｒＴ３明显高于对照组，有显著性差异。肝硬变组Ｃｈｉｌｄ－Ｐｕｓｈ记分与ｒＴ３浓度呈正相关（ｒ＝０．４８，Ｐ＜０．０１），与Ｔ３、Ｔ４浓度无明确相关（Ｐ＞０．０５）。肝硬变组ＦＳＨ，ＬＨ和ＰＲＬ明显高于对照组；Ｔ和Ｅ２明显低于对照组。Ｃｈｉｌｄ－Ｐｕｇｈ记分与Ｔ水平呈负相关（ｒ＝一０．５８，Ｐ＜０．０１），与ＰＲＬ浓度呈正相关（ｒ＝０．３５，Ｐ＜０．０１），与ＦＳＨ，ＬＨ和Ｅ２无明确相关。提示肝功能受损可能是导致肝硬变患者甲状腺激素和性激素异常的重要原因，ｒＴ３、Ｔ和ＰＲＬ对肝硬变患者的预后有一定的指示意义。The serum concentrations of thyroid hormones, sex hormones and gonadotrophinwere measured in 77 male cirrhotic patients (cirrhosis group) and 34 health men (control group).The seventy of cirrhosis was graded according to Child-Pugh's classification. There were 24 gradeA, 32 grade B and 21 grade C patients. Serum triodothyroxine (T3) and thyroxine (T4) weresingificantlv lower in the cirrhosis group, but rT3 was significantly higher than the control group.There was a positive correlation between serum rT3 levels and Pugh's score (r = 0. 48,P < 0. 01). Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH)and prolatin (PRL) weresignificantly higher in the cirrhosis group than in the control group, serum testosterone (T) andestradiol (E2) were significantly lower in the cirrhosis group than in the control group. There wasnegative correlation between serum T levels and Pugh's score (r = - 0. 58,P < 0. 01 ), but apositive correlation between Pugh's score and PRL level (r = 0. 35,P < 0. 01 ),and no markedcorrelation among FSH, LH and E2. The results suggested that impairment of liver functionsmight play a important role in the change of serum thyroid hormones and sex hormones andgonadotrophin in patients with cirrhosis, rT3、T and PRL might have the forecast effects onprognosis of the cirrohsis patients.

关 键 词：肝硬变 甲状腺激素 性激素 促性腺激素 

分 类 号：R575.2[医药卫生—消化系统]