Graves病患者肝功能不全的影响因素分析

Influencing Factors Analysis of Liver Dysfunction of Graves'Disease Patients

目的 探讨Graves病患者甲状腺激素与肝功能各指标间的关系以分析导致肝功能不全的主要因素。方法 选取2021年1月-2022年12月徐州市矿山医院核医学科收治的Graves病患者210例。检测所有患者的甲状腺功能及肝功能指标,分析Graves病患者肝功能不全的独立危险因素,以及肝功能指标与甲状腺激素的关联性。结果 210例患者中,有59%患者存在不同程度的肝功能不全,Logistic回归分析发现造成肝功能不全的影响因素中,血清FT3的OR值为1.105(95%CI 1.066~1.146,P=0.028),血清FT4的OR值为1.021(95%CI 1.008~1.034,P=0.002)。肝功能不全组中,AST与FT4呈正相关;ALT与FT3呈正相关;ALP与FT3呈正相关;GGT与FT3呈正相关;TBIL与TPOAb呈正相关;DBIL与FT3呈正相关。以上都有显著统计学差异(P<0.05)。结论 Graves病患者中血清FT3、FT4浓度较高更容易导致肝功能不全,是Graves病患者肝功能不全的独立危险因素。患者甲状腺功能异常的严重程度相关的因素可能导致Graves病患者肝功能不全的严重程度增加。

Objective To explore relationship between thyroid hormones and various indexes of liver function of patients with Graves disease,and analyze main factors causing liver dysfunction.Methods The paper chose 210 patients with Graves disease in nuclear medicine department of Xuzhou City Mine Hospital from January 2021 to December 2022,including 42 males and 168 females,detected thyroid function and liver function indexes of patients,and analyzed independent risk factors of liver dysfunction of Graves disease patients,and correlation between liver function indexes and thyroid hormones.Results Among 210 patients,59%had varying degrees of liver dysfunction.Logistic regression analysis found,among influencing factors of liver dysfunction,the OR value of serum FT3 was 1.105(95%CI 1.066~1.146,P=0.028),and the OR value of serum FT4 was 1.021(95%CI 1.008~1.034,P=0.002),with significant statistical difference between two groups(P<0.05).In group of liver dysfunction,AST was positively correlated with FT4;ALT was positively correlated with FT3;ALP was positively correlated with FT3;GGT was positively correlated with FT3;TBIL was positively correlated with TPOAb;DBIL was positively correlated with FT3.All of above showed significant statistical difference(P<0.05).Conclusion Graves disease patients with higher serum FT3 and FT4 concentrations may have liver dysfunction,which is an independent risk factor for liver dysfunction of Graves disease patients.Factors related to severity of thyroid dysfunction of patients may cause severity increase of liver dysfunction of Graves disease patients.