Graves病患者甲亢性肝损伤的相关因素分析

Analysis of Related Factors of Hyperthyroid Liver Injury in Patients with Graves Disease

目的:分析Graves病甲亢性肝损伤的临床特点,探讨发生甲亢性肝损伤的影响因素。方法:回顾性分析2017年1月-2022年4月于辽宁中医药大学附属医院内分泌科门诊就诊的316例Graves病患者的临床资料,收集患者就诊时甲状腺功能和肝功能指标。根据患者肝功能情况分为甲亢性肝损伤组(n=157)与肝功能正常组(n=159)。比较两组患者的甲状腺功能和肝功能指标,采用Spearman相关性分析探讨甲状腺功能与肝功能之间的相关性。logistic回归分析Graves病患者发生甲亢性肝损伤的独立危险因素。结果:甲亢性肝损伤组患者游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素受体抗体(TRAb)水平均高于肝功能正常组,促甲状腺激素(TSH)水平低于肝功能正常组,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,碱性磷酸酶(alkaline phosphatase,ALP)、γ-谷氨酰转移酶(γglutamyltranseferase,GGT)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)与FT_(3)、FT_(4)、TRAb水平呈正相关,与TSH水平呈负相关(P<0.05)。logistic回归分析显示,FT_(3)[OR=1.036,95%CI(1.008,1.066)]、TRAb[OR=1.029,95%CI(1.004,1.054)]为Graves病患者发生甲亢性肝损伤的影响因素(P<0.05)。结论:Graves病患者发生甲亢性肝损伤与FT_(3)、FT_(4)、TSH、TRAb相关,其中FT_(3)、TRAb为甲亢性肝损伤发生的独立危险因素。

Objective:To analyze the clinical characteristics of hyperthyroid liver injury in Graves disease and explore the influencing factors of hyperthyroid liver injury.Method:The clinical data of 316 patients with Graves disease admitted to the Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2017 to April 2022 were retrospectively analyzed,and thyroid function and liver function indexes were collected.Patients were divided into the hyperthyroid liver injury group(n=157)and the normal liver function group(n=159)according to their liver function conditions.The thyroid function and liver function indexes of the two groups were compared,and the correlation between thyroid function and liver function was discussed by Spearman correlation analysis.logistic regression analysis was performed for the independent risk factors of hyperthyroid liver injury in Graves patients.Result:The levels of free triiodothyroxine(FT_(3)),free thyroxine(FT_(4))and thyrotrophin receptor antibody(TRAb)in hyperthyroid liver injury group were higher than those in normal liver function group,while the level of thyroid stimulating hormone(TSH)was lower than that in normal liver function group(P<0.05).Spearman correlation analysis showed that alkaline phosphatase(ALP),γglutamyltranseferase(GGT),alanine aminotransferase(ALT),aspartate aminotransferase(AST)were positively correlated with FT_(3),FT_(4),TRAb levels,and negatively correlated with TSH levels(P<0.05).logistic regression analysis showed that FT_(3)[OR=1.036,95%CI(1.008,1.066)],TRAb[OR=1.029,95%CI(1.004,1.054)]were the risk factors for hyperthyroid liver injury in patients with Graves disease(P<0.05).Conclusion:FT_(3),FT_(4),TSH and TRAb are related to hyperthyroid liver injury in Graves disease patients,and FT_(3) and TRAb are independent risk factors for hyperthyroid liver injury.