重型肝炎病人甲状腺激素水平变化与临床意义

The changes and its clinical significance of thyroid hormone level in patients of severe hepatitis

目的 研究病毒性重型肝炎甲状腺激素水平的变化与临床意义。方法 采用放射免疫和包被管免疫放射分析 (IR MA)法检测 73例重型肝炎患者FT3、FT4 、TSH值 ,并与 40例慢性肝炎、40例正常健康者对照比较 ;分析重型肝炎存活组与死亡组以及存活组治疗前后FT3、FT4 、TSH的变化情况。结果 与慢性肝炎组、正常对照组比较 ,重型肝炎组FT3、FT4 明显下降 (P <0 .0 1) ,TSH改变不明显 ;重型肝炎死亡组FT3、FT4 比存活组明显下降 (P <0 .0 1)、TSH升高 (P <0 .0 5 ) ;重型肝炎存活组治疗后FT3、FT4 比治疗前升高 (P <0 .0 5 )。结论 甲状腺功能可随肝炎病情变化而改变 ,甲状腺激素水平的检测可作为反映病情严重程度和评估预后的一项参考指标 ,具有较高的临床价值。

Objective To study the changes of thyroid hormone level and its clinical significance in patients with severe viral hepatitis.Methods FT 3, FT 4, TSH of 73 cases with severe hepatitis were detected by means of radioimmunometry and immunoradiometry analysis (IRMA) and comparisons with that of 40 cases in chronic hepatitis group and 40 cases in normal control group were made. Changes of FT 3, FT 4 and TSH in severe hepatitis survival group and dead group, also in survival group before and after treatment were studied.Results Compared with chronic hepatitis group and normal control group, FT 3, FT 4 decreased obviously in severe hepatitis group(P<0.01), while TSH seen no obvious change. FT 3, FT 4 in dead group of severe hepatitis decreased more obviously than that in survival group (P<0.01), TSH also rose in certain degree. After treatments, FT 3, FT 4 level in severe hepatitis survival group was higher than that of before the treatments (P<0.05).Conclusion Thyroid function could change with the changes of the illness states of hepatitis, detection of thyroid hormone level could be considered as a reference index that reflected the severe degree of the illness state of severe hepatitis and help to make an estimation of the prognosis of the disease, thus it has a significant clinical application value.