聚乙二醇干扰素α治疗慢性乙型肝炎诱发甲状腺疾病的临床研究

Prevalence and clinical characteristics of thyroid disease induced by chronic hepatitis B treated with polyethylene glycol （peg） interferon-α

目的探讨聚乙二醇干扰素α治疗慢性乙型肝炎期间甲状腺疾病发生情况及其临床特点。方法对210例应用聚乙二醇干扰素α治疗的慢性乙肝患者在治疗前、治疗中每3个月检测甲状腺功能及甲状腺抗体。结果聚乙二醇干扰素α治疗后，6．7％（14／210）出现甲状腺疾病，其中5．2％（11／210）甲状腺功能亢进，1．4％（3／210）甲状腺功能减退。女性发生甲状腺功能亢进及甲状腺功能减退的比例分别为11．8％（6／51）和3．9％（2／51），高于男性的3．1％（5／159）和0．6％（1／159），两组间差异有统计学意义，P〈0．05。女性、治疗前TPOAb阳性及治疗中TgAb阳性患者出现甲状腺疾病比例增高，与未出现甲状腺疾病者相比，差异有统计学意义，P〈0．05。结论聚乙二醇干扰素α治疗慢性乙型肝炎可引起甲状腺疾病。女性、TPOAb及TgAb阳性患者发生甲状腺疾病的风险增高。

Objective To study the prevalence and clinical characteristics of thyroid disease induced by chronic hepatitis B treated with polyethylene glycol （peg） interferon-α. Methods Totally 210 patients with chronic hepatitis B were monitored for thyroid function and thyroid antibodies before application of polyethylene glycol （peg） interferon-or therapy and every 3 months during and after the treatment. Results After treatment with polyethylene glycol （peg） interferon-α, 6.7% （14/210） of patients had thyroid disease, in which 5.2% （11/210） had hyperthyroidism and 1.4% （3/210） had hypothyroidism. The proportion of the hyperthyroidism and hypothyroidism in women were 11.8% （6/51） and 3.9% （2/51） , higher than 3.1% （5/159） and 0.6% （1/159） in male （P 〈 0.05）. In women subjects, higher proportion of those who developed thyroid disease were positive for antibody against thyroid peroxidase （TPOAb） before treatment and positive for antibody against thyroid globulin （TgAb） during the treatment as compared with those who did not develop thyroid disease （ P 〈 0.05 ）. Conclusion Patients with chronic hepatitis B treated with polyethylene glycol （peg） interferon-α therapy are prone to develop thyroid disease. Women positive for TPOAb and TgAb may be at increased risk for developing thyroid disease.