丙型肝炎患者干扰素治疗期间甲状腺功能异常的危险因素分析

Occurrence and risk factors of thyroid dysfunction in chronic hepatitis C patient received interferon treat-ment

目的：探讨慢性丙型肝炎（CHC）患者抗病毒治疗对甲状腺功能的影响及其相关危险因素。方法对采用聚乙二醇干扰素（PegIFN α-2a）联合利巴韦林（RBV）治疗的122例 CHC 患者的临床资料进行回顾性分析。所有患者治疗前甲状腺功能均正常，根据治疗后是否出现甲状腺功能异常分为甲状腺功能正常组和甲状腺功能异常组，采用病例对照研究的方法并采用 Logistic 回归分析甲状腺功能异常的相关危险因素。结果122例 CHC 患者均完成48周疗程，且随访24周，其中34例患者发生甲状腺功能异常，发生率为27．9％。Logistic 回归分析显示，女性、甲状腺自身抗体阳性、非医保和吸烟可能是发生甲状腺功能异常的危险因素（OR ＝4．470、4．757、3．828和7．306，P ＜0．05或 P ＜0．01）。结论干扰素联合 RBV 治疗 CHC 期间，患者甲状腺功能异常的发生率较高，其中女性、甲状腺自身抗体阳性、非医保和吸烟可能是导致甲状腺功能异常的危险因素。

Objective To investigate the antiviral treatment for patients with chronic hepatitis c（CHC）the influence of thyroid function and its related risk factors.Methods Used polyethylene glycol （peg） interferon （PegIFN α-2a）plus ribavirin （RBV）for the treatment of 122 cases of patients with CHC data were retrospectively analyzed.All of the patients before treatment thyroid function were normal.According to the thyroid function after treatment they were divided into normal thyroid function and abnormal thyroid function groups.Adopting the method of case -control study and Logistic regression we analyzed correlative risk factors of thyroid dysfunction.Results 122 CHC patients completed 48 weeks of treatment,and follow -up of 24 weeks,34 patients with thyroid dysfunction,rate of 27.9%. Logistic regression analysis showed that women,a positive thyroid autoantibodies,health care and smoking might be risk factor for thyroid dysfunction（OR =4.470,4.470,4.757 and 7.306,P 〈0.05 or P 〈0.01）.Conclusion Inter-feron plus RBV during the treatment of CHC patients with a high incidence of thyroid dysfunction,including women,a positive thyroid autoantibodies,the health,and smoking could be a risk factor for thyroid dysfunction.