30例甲状腺功能亢进性肝功能损害的临床特点及预后因素分析

Clinical characteristics and prognostic factors of 30 patients with hyperthyroidism liver injury

目的探讨甲状腺功能亢进性肝功能损害(hyperthyroidism liver injury HLI)的临床特点和影响预后的因素。方法 30例HLI患者临床资料的回顾性总结分析。结果所有患者入院时均存在不明原因肝功能不全,而后明确为HLI。肝功能结果异常主要表现为ALT升高和AST升高为主,其次是GGT、DB、TB、ALP升高以及ALB下降。Logistic回归分析显示入院时TB与HLI患者的预后相关(P<0.05,OR=0.992,95%CI=0.985-0.999)。结论此类患者可同时具备甲亢和肝功不全的临床表现,肝功常表现为淤胆型肝炎。HLI总体预后较好,患者入院时TB升高可能是影响预后的因素。

Objective To investigate the clinical characters and the prognostic factors of hyperthyroidism liver injury （HLI）. Methods Data of 30 patients with HLI were retrospectively analyzed. Results The patients, which were admitted by liver dysfunction and then diagnosed by HLI.The elevations of ALT and AST were most frequently detected, followed by increased GGT , DB , TB and ALP, and decreased ALB. Logistic regression analysis revealed that TB was related to the prognosis （P〈0.05, OR=0.992, 95%CI=0.985-0.999）. Conclusion These patients presented the clinical manifestations of hyperthyroidism and liver dysfunction, while the results of liver function were characterized by cholestatic hepatitis. This study indicates that more understanding of HLI should be emphasized in case of missed-diagnosis or misdiagnosis. The disease has a relative good prognosis, which might be related to TB elevation.