Graves病甲状腺功能亢进症性肝损害的相关因素分析  

Related factors of hyperthyroidism-related liver dysfunction in Graves＇ disease

作　　者：朱萍[1] 卫红艳[1] 王坤玲[1] 汤绍芳[1] 马中书[1] Zhu Ping Wei Hongyan Wang Kunling Tang Shaofang Ma Zhoagshu.(Department of Endocrinology and Metabolism, The General Hospital, Tianjin Medical University, Tianfin 300052, Chin)

机构地区：[1]天津医科大学总医院内分泌代谢科,300052

出　　处：《国际内分泌代谢杂志》2017年第3期164-167,F0003,共5页International Journal of Endocrinology and Metabolism

摘　　要：目的探讨影响Graves病甲状腺功能亢进症（甲亢）性肝功能损害的相关因素。方法回顾性分析天津医科大学总医院2013年1月至2015年12月收治的Graves病住院患者254例，根据肝功能将患者分为Graves病甲亢性肝损害组（A组，n=159）和甲亢肝功能正常组（B组，n=95），比较两组的基础代谢率（BMR）、甲状腺重量、FB、FT4、促甲状腺激素（TSH）、TSH受体抗体（TRAb）、甲状腺球蛋白抗体（TgAb）、甲状腺过氧化物酶抗体（TPOAb）。采用Pearson相关性分析甲状腺重量、BMR、FT3、FT4、TRAb与甲亢性肝损害的相关性，应用Logistic回归分析甲亢性肝损害的独立危险因素。结果A组的甲状腺重量、BMR、FT3、FT4、TRAb、TPOAb均高于B组，而TSH低于B组（t或z=-4．720～-2．276，P均〈0．05）。Pearson相关性分析显示，甲状腺重量、BMR、FT3、FT4、TRAb与甲亢性肝损害的发生呈正相关（r=0．157～0．270，P均〈0．05）。Logistic回归分析显示，FT3（OR=1．052，95％CI：1．001～1．105）、BMR（OR=1．019，95％CI：1．006-1．033）是Graves病甲亢性肝损害发生的独立危险因素（P均〈0．05）。结论Graves病甲亢性肝损害与FT3、FT4、TRAb、BMR、甲状腺重量有关。其中FT3、BMR为甲亢性肝损害发生的独立危险因素。Objective To investigate the related factors of hyperthyroidism-related liver dysfunction in Graves＇ disease. Methods A total of 254 patients with Graves＇ disease hospitalized in the General Hospital of Tianjin Medical University from January 2013 to December 2015 were enrolled and divided into two groups based on liver function： Graves＇ disease with abnormal liver function group（group A, n = 159）, and normal hepatic function group（ group B, n =95）. The basal metabolic rate（ BMR）, weight of thyroid gland, FT3, FF4, thyroid-stimulating hormone （ TSH ）, anti-thyrotrophin receptor antibody （ TRAb ）, thyroglobulin antibody （TgAb） , anti-thyroid peroxidase antibody（TPOAb） were compared between the two groups. Pear- son correlation was used to analyze the correlation between thyroid weight, BMR, FT3 , FT4, TRAb and hyperthyroidism-related liver dysfunction. Logistic regression was used to analyze the independent risk factors of hyperthyroidism-related liver function. Results The weight of thyroid gland, BMR, FT3, FT4, TRAb and TPOAb in group A were higher than those in group B, while TSH in group A was lower than that in group B （ t or z = - 4. 720- - 2. 276, all P 〈0. 05 ）. Pearson correlation analysis showed that hyperthyroidism-related liver dysfunction was positively related to the weight of thyroid gland, BMR, FT3, FT4 and TRAh （r =0. 157-0.270, all P 〈0.05 ）. Logistic regression analysis showed that FT3 （ OR = 1. 052, 95% CI： 1. 001-1. 105） and BMR （ OR = 1. 019, 95% CI： 1. 006-1. 033） were the independent risk factors for hyperthyroidism-related liver dysfunction in Graves＇ disease （ all P 〈 0.05 ）. Conclusion The risk factors of hyperthyroidism-related liver dysfunction in Graves＇ disease include weight of thyroid gland, BMR, FT3, FT4 and TRAb. BMR and FT3 are the independent risk factors for hyperthyroidism-related liver dysfunction in Graves＇ disease.

关 键 词：GRAVES病 甲状腺功能亢进症 肝功能损害 甲状腺激素 

分 类 号：R575[医药卫生—消化系统] R581.1[医药卫生—内科学]