肝病患者血清甲状腺激素变化

THYROID HORMONE CHANGES IN PATIENT WITH HEPATIC DISEASE

测定１０９例不同肝病患者的血清甲状腺激素，与对照组比较，肝炎组Ｔ４、ｒＴ３、ｒＴ３／Ｔ３升高（Ｐ＜０．０５），Ｔ３／Ｔ４降低（Ｐ＜０．０１）。肝硬化组Ｔ３、Ｔ３／Ｔ４降低（Ｐ＜０．０１），ｒＴ３、ｒＴ３／Ｔ３升高（Ｐ＜０．０５），部分重症患者伴有Ｔ４降低。血清Ｔ３、Ｔ４与肝病患者血清胆红素、血浆白蛋白密切相关。血清Ｔ３含量尤其是Ｔ４浓度可预测肝病患者的预后，讨论了甲状腺激素浓度异常的发生机理和临床意义。

Serum thyroid hormones were determined in 109 patients with hepatic disease. The results were compared with controls. T 4, rT 3 and ratio of rT 3/T 3 were significantly increased (P<0.05),but the ratio of T 3/T 4 was decreased significantly (P< 0.01) in patients with hepatitis. In patients with liver cirrhosis, the serum concentrations of T 3 and ratio of T 3/T 4 were lower (P<0.01),while rT 3 and ratio of rT 3/T 3 were higher (P< 0.05). Low level of serum T 4 was found in some severe cases with liver cirrhosis. The serum concentrations of T 3, T 4 correlated closely with that of bilirubin and albumin. Serum concentration of T 3, especially T 4 could indicated the prognosis of patients with hepatic disease. The mechanism of thyroid hormone changes and clinical significance were discussed.