慢性丙型病毒性肝炎治疗中发生甲状腺功能异常的危险因素  

Risk factors of thyroid dysfuction in the anti- virus therapy of chronic hepatitis C

作　　者：叶敏贞[1,2] 谢青[1] 陈翠玲[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院感染科,上海200025 [2]三明市中西医结合医院肝病专科,福建三明365001

出　　处：《中国临床药理学杂志》2015年第16期1585-1587,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探讨慢性丙型病毒性肝炎(丙肝)抗病毒治疗中发生甲状腺功能异常的危险因素。方法 131例慢性丙肝患者皮下注射聚乙二醇干扰素α-2a(Peg-IFN-α-2a)180μg,1周1次,联合口服利巴韦林15 mg·kg-1,每日1次,总疗程48周。检测患者治疗前2周内及治疗12,24,36,48周的游离甲状腺激素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)水平和抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)水平。结果治疗后,甲状腺功能异常的发生率为10.69%(14/131),TGAb基线阳性者甲状腺功能异常率为35.7%,高于TGAb阴性者的7.7%,TPOAb的基线阳性者甲状腺功能异常率为57.1%,高于TPOAb阴性者的0.9%(P<0.05)。性别、年龄、干扰素使用疗程等因素与甲状腺功能异常的发生无统计学关联(P>0.05)。结论甲状腺TPOAb、TGAb基线阳性是抗病毒治疗后发生甲状腺功能异常的危险因素,可作为慢性丙肝抗病毒治疗中发生甲状腺功能异常不良反应的监测指标。Objective To explore risk factors of thyroid dysfunction during anti- virus therapy in patients with chronic hepatitis C.Methods A total of 131 patients with chronic hepatitis C who received IFN- α- 2a 180 μg once a week and ribavirin 15 mg·kg^- 1,qd were chosen. The treatment lasted 48 weeks. The data of thyroid function and thyroid antibodies [FT3,FT4,TSH,antithyroid peroxidase autoantibody（ TPOAb）,and thyroglobulin antibody（ TGAb） ] were tested within 2weeks before therapy and 12,24,36 and 48 weeks during the course.Results In 131 cases of chronic hepatitis C,the incidence of thyroid dysfunction was 10. 69%（ 14 /131）. The incidence of TGAb at baseline positive in thyroid dysfunction group was significantly higher than that in normal thyroid function group（ 35. 7% vs 7. 7%, P〈0. 05）. The incidence of TPOAb at baseline positive in thyroid dysfunction group was significantly higher than that in normal thyroid function group（ 57. 1% vs0. 9%,P〈0. 05）. There was no significant differences in the data of sex,age,and period of treatment of interferon in the area of thyroid dysfunction. Conclusion Presence of elevated TGAb and TPOAb are the main risk factors for the thyroid dysfunction during anti- virus therapy in patients with chronic hepatitis C. TGAb and TPOAb can be used as untoward effect monitoring indexes during the anti- virus therapy.

关 键 词：慢性丙型肝炎 抗病毒治疗 甲状腺功能异常 危险因素 

分 类 号：R512.63[医药卫生—内科学] R978.7[医药卫生—临床医学]