肝硬化患者血清甲状腺激素水平与肝硬化严重程度的关系  

Relationship between serum thyroid hormone level and severity of cirrhosis

作　　者：吴文文 陈永忠[1] 仝亚林[1] Wu Wenwen;Chen Yongzhong;Tong Yalin(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化科,450052

出　　处：《中国实用医刊》2019年第22期34-37,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨肝硬化患者血清甲状腺激素水平与肝硬化分级、并发症及肝功能之间的关系.方法收集2018年1月至2018年12月于郑州大学第一附属医院就诊的肝硬化患者121例作为肝硬化组,并且按Child-Pugh分级标准分级,另选取101例健康者作为对照组,检测所有研究对象甲状腺激素水平及肝功能,比较对照组与肝硬化组、肝硬化组各级之间、肝硬化并发症组与无并发症组之间血清甲状腺激素水平,并研究肝功能与甲状腺激素水平的相关性.结果肝硬化患者的FT3水平低于对照组,随着Child-Pugh分级增加,血清游离三碘甲腺原氨酸(FT3)水平逐渐降低(P<0.01);合并腹水、肝性脑病及食管/胃底静脉曲张破裂出血者,FT3水平均较无并发症者低(P<0.01).FT3与丙氨酸氨基转移酶(ALT)、血清总胆红素(TB)呈负相关(r值分别为-0.21、-0.478,P<0.05),FT3与血清白蛋白(ALB)、胆碱酯酶(CHE)呈正相关(r值分别为0.599、0.326,P<0.05);血清游离甲状腺素(FT4)与ALB、CHE呈负相关(r值分别为-0.231、-0.292,P<0.05),促甲状腺激素(TSH)与ALB呈负相关(r值为-0.183,P值<0.05).结论肝硬化患者病情越严重,FT3水平越低,FT3与肝功能的损害程度具有相关性,对判断肝硬化患者的严重程度有重要价值,可以在今后患者的诊疗过程中应用.Objective To explore the relationship between serum thyroid hormone level and severity of cirrhosis,complications and liver function in patients with liver cirrhosis.Methods A total of 121 patients with cirrhosis who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2018 were selected as the cirrhosis group,and they were classified by Child-Pugh classification.And 101 healthy subjects were selected as the control group.Thyroid hormone level and liver function was detected in all the study objects.Serum thyroid hormone levels were compared between control group and cirrhosis group,among every subgroups of cirrhosis group,between cirrhosis complication group and non-complication group.The correlation between liver function and thyroid hormone level was also studied.Results The level of serum free triiodothyronine(FT3)in patients with cirrhosis was significantly lower than that in the control group,and the level of FT3 decreased gradually with the increase of Child-Pugh classification(P<0.01).FT3 levels of the patients complicated by ascites,hepatic encephalopathy or esophageal/gastric varices bleeding were lower than those without complications(P<0.01).FT3 was negatively correlated with alanine aminotransferase and serum total bilirubin(r=-0.21,-0.478;P<0.05);however FT3 was positively correlated with serum albumin(ALB)and cholinesterase(CHE,r=0.599,0.326 respectively,P<0.05);serum free thyroxine(FT4)was negatively correlated with ALB,and CHE(r=-0.231,-0.292;P<0.05),and thyrotropin(TSH)was negatively correlated with ALB(r=-0.183,P<0.05).Conclusions For patients with cirrhosis,the more severe disease progresses,the lower the level of FT3 decreases,And the level of FT3 is closely related to the degree of liver function damage,which is of great value to judging the severity of patients with cirrhosis,and can be used in the diagnosis and treatment of patients.

关 键 词：肝硬化 甲状腺激素 CHILD-PUGH分级 肝功能 

分 类 号：R575.2[医药卫生—消化系统]