促甲状腺激素与慢性乙型肝炎肝纤维化严重程度的关联性研究  

Relationship between serum thyroid stimulating hormone level and the severity of hepatic fibrosis in patients with chronic hepatitis B

作　　者：朱俊民[1] 孟春阳[1] 夏丽娜[1] 王媛媛[1] ZHU Jun-min;MENG Chun-yang;XIA Li-na;WANG Yuan-yuan(Henan Luohe Central Hospital Laboratory,Luohe,Henan 462000,China)

机构地区：[1]河南省漯河市中心医院检验科,河南462000

出　　处：《中国地方病防治》2022年第2期139-142,共4页Chinese Journal of Control of Endemic Diseases

摘　　要：目的 探讨血清促甲状腺激素(TSH)水平与慢性乙型肝炎(CHB)患者肝纤维化严重程度的相关性。方法 选取2018年1月至2020年12月某院感染科收治的CHB患者500例为研究对象,根据Fibroscan检查结果,将所有研究对象分为无纤维化组(n=161)、轻度纤维化组(n=144)、中度纤维化组(n=115)和重度肝纤维化组(n=80),比较各组血清TSH水平的差异,采用logistic回归分析血清TSH水平与肝纤维化严重程度的关系。结果 (1)随着肝纤维化严重程度的增加,血清TSH水平逐渐升高;(2)肝硬度值与血清TSH水平呈正相关(r=0.262,P<0.05);(3)多元logistic回归分析提示,血清TSH水平是轻度肝纤维化(OR=1.987,95%CI 1.473~2.582,P=0.007)和中-重度肝纤维化(OR=1.743,95%CI 1.225~2.189,P=0.012)的独立危险因素;(4)随着TSH水平的升高,无纤维化的比例逐渐降低(53.01%vs 30.54%vs 13.17%,P<0.05),轻度肝纤维化(22.89%vs 29.34%vs 34.13%,P<0.05)和中-重度肝纤维化(24.10%vs 40.12%vs 52.70%,P<0.05)的发生率逐渐升高。结论 血清TSH水平与CHB患者肝纤维化严重程度密切相关。Objective To investigate the association of serum thyroid stimulating hormone(TSH) level with the severity of hepatic fibrosis in patients with chronic hepatitis B(CHB).Methods A total of 500 CHB patients were enrolled as study subjects by the department of infectious diseases in one hospital from January 2018 to December 2020.All participants were divided into four groups according to the results of Fibroscan: the no fibrosis group(n=161),the mild fibrosis group(n=144),the moderate fibrosis(n=115) and the severe fibrosis(n=80).The difference of serum TSH level in each group was compared.logistic regression analyses were used to explore the relationship between serum TSH level and hepatic fibrosis severity.Results(1)With the increase of the severity of liver fibrosis, serum TSH level increased gradually;(2)There was a positive correlation between liver stiffness value and serum TSH level(r=0.262,P<0.05);(3)Multiple logistic regression analysis showed that serum TSH level was an independent risk factor for mild liver fibrosis(OR=1.987,95%CI 1.473-2.582,P=0.007) and moderate to severe liver fibrosis(OR=1.743,95%CI 1.225-2.189,P=0.012);(4)With the increase of serum TSH level, the proportion of no fibrosis decreased gradually(53.01% vs 30.54% vs 13.17%,P<0.05),while the incidence of mild liver fibrosis(22.89% vs 29.34% vs 34.13%,P<0.05) and moderate to severe liver fibrosis(24.10% vs 40.12% vs 52.70%,P<0.05) gradually increased.Conclusion Serum TSH level is closely related to the severity of liver fibrosis in CHB patients.

关 键 词：促甲状腺激素 肝纤维化 慢性乙型肝炎 

分 类 号：R581[医药卫生—内分泌]