重型肝炎血清甲状腺素水平变化及其临床意义

The change of serum thyroxin in patients with grave hepatitis and its clinical significance

目的 探讨重型肝炎(重肝)血清甲状腺素水平与肝损害程度关系及意义。方法 放免法测定33例重肝、39例急性肝炎及30例正常人血清甲状腺素水平。结果 重肝T_3、T_4、TSH水平显著低于另外两组,rT_3则增高;T_3、T_4与血浆白蛋白呈正相关,T_3、TSH与凝血酶原时间、rT_3与谷丙转氨酶呈负相关;重肝死亡者T_3、T_4、TSH低于存活者,rT_3则增高。结论 重肝病人甲状腺素水平可作为反映肝功能的敏感指标,对判断疾病严重程度、预后很有价值。

Objective To study the relationship between metabolizing disorder of serum thyroxin and the degree of liver damage in patients with grave hepatitis and its clinical significance. Methods Using radiation immune assay(RIA) to detect of serum thyroxin of 33 patients with grave hepatitis,39 patients with acute hepatitis and 30 healthy persons. Results Serum T3 ,T.4 ,TSH in patients with grave hepatitis were significantly lower than those in patients with acute hepatitis and healthy persous(P<0. 05) ,and the level of serum rT3 was significantly higher(P < 0. 05) . Serum T3, T4 and TSH in patients who died of grave hepatitis was significantly lower than survival P < 0. 01) ,and serum rT3 was significantly higher.Serum T3,T4 and albumin, T3,TSH and PT,rT3 and ALT were closely correlated respectively. Conclusion Serum thyroxin is significantly abnormal in patients with grave hepatitis, and the more serious the state is, the worse the prognosis is. The serum thyroxin is a sensitive index, which can reflect liver function,and is helpful for judging the degree of hepatitis and its prognosis.