肝硬化患者血清甲状腺激素水平变化的临床研究

目的探讨肝硬化患者血清甲状腺激素水平的变化与肝硬化Child-Pugh分级的关系。方法选择2005年10月至2007年12月中山市黄圃人民医院门诊、内科就诊的患者98例,经血清生化学、血清AFP、HA、PⅢP、Ⅳ-C及LN检测以及B超、X-CT等影像学检查得以证实为肝硬化。同期查体健康者30名作为对照组。检测两组T3、T4、FT3、FT4、sTSH、血清白蛋白、凝血酶原时间和总胆红素的关系等生化指标,比较T3、T4、FT3、FT4、sISH的水平与肝硬化Child-Pugh分级的关系。结果肝硬化组的血清T3、T4、FT3、FT4与对照组相比均有下降,相对应指标间的差异有统计学意义(P<0.05);肝硬化组血清sTSH水平与对照组相比均无差异有统计学意义(P>0.05),且T3、T4、FT3、FT4的下降程度与肝硬化Child-Pugh分级呈正相关。结论肝硬化患者血清甲状腺激素水平的变化可作为判断疾病病情一个有效指标,通过血清甲状腺激素水平的监测可判断疾病状况、治疗效果及预后。

Objective To explore the interrelation between serum thyroxine and Child-Pugh Classification in patients with liver cirrhosis.Methods 98 cases patients in outpatient and Medical Department of The People's Hospital of Huangpu were included in this study.The concentrations of thyroxine were determined by electrochemi luminescence immunoassay in all cases.We analyzed the relationship between the concentration of T3,T4,FT3,FT4,sTSH and Child-Pugh Classification.Results It showed that the serum thyroxine decreased gradually with the degree of clinical liver cirrhosis deteriorated.It is suggested that there is significantly negative relation betweenT3,T4,FT3,FT4 and Child-Pugh Classification.Conclusion Measuring the concentration of thyroxine has utilizable and reliable clinical value in predicting the degrees and prognosis of liver cirrhosis.