肝硬化患者血清甲状腺激素水平变化的临床意义

Clinical significance of the serum thyroxin level in patients with liver cirrhosis

[目的]研究肝硬化患者的血清甲状腺激素水平变化及其临床意义。[方法]用电化学发光法检测了104例肝硬化患者促甲状腺素(TSH)、血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,并与健康体检者对照。按照肝功能分级(Child-Pugh积分法)比较。[结果]肝硬化患者血清FT3、FT4较正常对照组显著降低(t=11.586、5.309,P<0.001);肝功能B级患者的FT3较A级下降(P=0.003),肝功能C级患者的FT3较A级明显下降(P<0.001);肝硬化患者Child-Pugh肝功能分级与FT3负相关(r=-0.370,P<0.001)。[结论]随着肝硬化肝功能损害程度的加重,血清FT3、FT4呈下降趋势,血清FT3水平与肝功能损害程度密切相关。血清FT3水平变化对判断肝硬化严重程度,指导临床治疗及判断预后具有一定的临床价值。

[Objective]To study the clinical significance of the serum thyroxin level in patients with liver cirrhosis（LC）.[Methods]The concentration of serum FT3,FT4 and TSH were detected by electric chemiluminescence in 104 patients with liver cirrhosis.Healthy subjects were observed as control group.Liver function classification（Child-Pugh）were compared.[Results]Contents of serum FT3,FT4 in LC patients were markedly lower than those of the control group（t=11.586,5.309,P0.001）.Serum FT3 in B degree of liver function was lower than that in A degree（P=0.003）.Serum FT3 in C degree was also significantly lower than that in A degree（P0.001）.There was a negative correlation between serum FT3 and liver function classification（Child-Pugh）in patients of LC（r=-0.370,P0.001）.[Conclusion]The serum FT3 and FT4decreased gradually with the progression of clinical liver cirrhosis deteriorated degree.There was a significant correlation between FT3 and liver functions.Changes of the serum thyroxin level in patients with liver cirrhosis had reliable clinical value in the treatment of LC and predicting the prognosis of liver cirrhosis.