慢性丙型肝炎与结节性甲状腺肿的相关性分析

Correlation analysis of chronic hepatitis C with nodular goiter

目的 探讨丙型肝炎病毒感染与结节性甲状腺肿的相关性. 方法 97例初治慢性丙型肝炎患者,收集年龄、性别、病程等一般资料,同时检测甲状腺功能（包括T3、T4、TSH）及甲状腺自身抗体（甲状腺过氧化物酶抗体TPO-Ab、甲状腺球蛋白抗体Tg-Ab）、甲状腺三维彩色超声检查.以111例初治慢性乙型肝炎患者和106例年龄大于40岁的女性结节性甲状腺肿高危人群做对照,分析结节性甲状腺肿与甲状腺功能、甲状腺自身抗体、性别、年龄、丙型肝炎病毒感染之间的关系.计量资料用（-x＆#177;s）表示,均值的比较用方差分析,计数资料用率表示,率的比较用x2检验,对危险因素进行logistic回归分析.结果 慢性丙型肝炎组、慢性乙型肝炎组及女性结节性甲状腺肿高危人群组的结节性甲状腺肿的患病率分别是53.6％、36.9％、59.4％,三组间比较后发现慢性丙型肝炎组和女性结节性甲状腺肿高危组均明显高于慢性乙型肝炎组,差异有统计学意义（x2值分别是5.820、10.996,P＜ 0.05）.在慢性丙型肝炎合并结节性甲状腺肿组中,平均年龄显著高于阴性组（F=6.408,P＜0.05）,且年龄≥40岁组的结节性甲状腺肿患病率（60.0％）明显高于40岁以下人群组（23.5％）,差异有统计学意义（x2=7.499,P＜0.05）.慢性丙型肝炎女性结节性甲状腺肿患病率（62.1％）显著高于男性（41.0％）,差异有统计学意义（x2=4.152,P＜0.05）,且年龄≥40岁的女性慢性丙型肝炎患者的结节性甲状腺肿患病率（70.2％,33/47）明显高于男性（45.5％,15/33）,差异有统计学意义（x2=4.952,P＜0.05）.慢性丙型肝炎合并结节性甲状腺肿组在丙型肝炎病毒感染时间、甲状腺功能、甲状腺自身抗体上与结节性甲状腺阴性组比较,差异无统计学意义. 结论 慢性丙型肝炎患者的结节性甲状腺肿患病率较高,平均可达53.6％,其中年龄≥40岁的女性患者结节性甲状腺肿患病率可高达70.2％,明显高于慢性乙型肝炎患者及结节性甲状腺肿高危人群,提示对患慢性丙型肝炎的患者应该常规做甲状腺的超声检查.慢性丙型肝炎合并结节性甲状腺肿与甲状腺功能、甲状腺自身抗体之间无相关性.

Objective To assess the relationship between nodular goiter and hepatitis C virus infection.Methods Ninety-seven cases of early treatment in patients with chronic hepatitis C were collected for analysis.Data on patient age,sex,hepatitis duration and other general information were collected.In addition,data on clinical measures of thyroid function （including T3,T4,TSH） and thyroid autoantibodies （thyroid peroxidase antibody TPO-Ab,thyroglobulin antibody Tg-Ab）,as well as findings from thyroid dimensional ultrasonography were collected.One hundred and eleven cases of early treatment in patients with chronic hepatitis B and 106 eases of females 40 years old or older with high risk of nodular goiter were collected for use as controls.The relationship between nodular goiter with thyroid function,thyroid autoantibodies levels,sex,age,and hepatitis C virus infection were statistically analyzed.Results The prevalence rates of nodular goiter in the chronic hepatitis C group,the chronic hepatitis B group and the ≥ 40 year-old women with high risk of nodular goiter were 53.6%,36.9% and 59.4% respectively.The prevalence rates of nodular goiter in the chronic hepatitis C group and the ≥ 40 year-old women with high risk of nodular goiter were significantly higber than that in the chronic hepatitis B group （x2 values：5.820 and 10.996,P 〈 0.05）.The average age of patients with chronic hepatitis C combined with nodular goiter was significantly higher than their counterparts without goiter （F =6.408,P 〈 0.05）,and the prevalence rate in the ≥ 40 year-old women with high risk of nodular goiter was significantly higher than that of their counterparts who were 〈 40 years-old （60.0% vs.23.5%; x2 =7.499,P 〈 0.05）.The prevalence of nodular goiter in patients with chronic hepatitis C was significantly greater for females than for males （62.1% vs.41.0%; x 2 =4.152,P 〈 0.05）.The prevalence of nodular goiter in patients with chronic hepatitis C was also significantly higher for females ≥ 40 years old than for males （70.2%,33/47 vs.45.5%,15/33;x2 =4.952,P 〈 0.05）.The duration of hepatitis,thyroid function and thyroid autoantibodies were similar between the patients in the chronic hepatitis C group with or without nodular goiter.Conclusions The patients with chronic hepatitis C had a higher prevalence of nodular goiter,with an average of up to 53.6%,than the patients with chronic hepatitis B,and the women the ≥ 40 years old had even higher prevalence,at 70.2%,suggesting that patients with chronic hepatitis C should be routinely examined by thyroid ultrasound.Thyroid function and thyroid autoantibodies were not correlated with prevalence of goiter among the chronic hepatitis C patients.