肝硬化患者甲状腺素、性激素变化水平及临床意义

A stduy on the levels of thyroid hormone and gonadal hormone in serum in patients with hepatocirrhosis

目的 :进一步了解肝硬化患者甲状腺素、性激素变化的具体规律 ,为判断及评估临床疗效提供参考依据。方法 :采用放射免疫法测定 34例不同程度、不同类型肝硬化患者血清中三碘甲状腺原氨酸 (T3 )、甲状腺素 (T4)、反 T3(r T3 )、T3 /r T3 、T4/r T3 、卵泡刺激素 (FSH)、黄体生成素 (L H)、催乳素 (PRL)、雌二醇 (E2 )、睾酮 (T)水平 ,并与 30例健康者对照。结果 :肝硬化组 T3 、T4明显下降 ,r T3 明显上升 ,与对照组比较存在明显差异 (P<0 .0 1) ,FSH、L H、PRL 明显上升 ,T、E2 显著下降 ,与对照组比较存在差异 (P<0 .0 1) ,且这种变化与 Child分级有关。结论 :肝硬化存在不同程度的甲状腺和性腺激素水平紊乱 ,紊乱与肝硬化时肝功能受损程度有明显关系 ,与肝硬化类型无关 ,测定上述两种激素的变化水平 ,可以作为临床判断好转、恶化疗效的指标。

Objective: The purpose of this study was to analyze the changes in thyroid hormone and gonadal hormone in patients with hepatocirrhosis,provide reference standard for clinical herapeutic evalution.Methods:The levels of T 3,T 4,rT 3,T 3/rT 3,T 4/rT 3,FSH,LH,PRL,E 2 and T in serum were measured by radioimmunity assay in patients with hepatocirrhosia.Results:There was a significant reduction in T 3 and T 4,a significant elevation in rT 3 in hepatocirrhosis group than in control group( P <0.01);There was a significant elevation in LH and PRL,a significant reduction in E 2,T in hepatocirrhosis group than in control group( P <0.01).These change were related to child grade.Conclusion:Hepatocirrhosis had varying amounts of disorder in levels of thyroid hormone and gonadal hormone in serum,depending on liver function lesion gravity,not hepatocirrhosis type,the determination of above hormone could be deserved as a standard for clinical state of illness.