低HBsAg水平乙型肝炎患者使用干扰素治疗期间HBsAg与TSH的关系

Relationship between HBsAG and TSH during interferon treatment in hepatitis B patients with low HBsAg level

目的探讨低乙型肝炎(乙肝)表面抗原(HBsAg)水平乙肝患者使用聚乙二醇干扰素α-2b(PEG-IFNα-2b)治疗时HBsAg与促甲状腺激素(TSH)的关系。方法选取2020-2022年在该院PEG-IFNα-2b联合核苷(酸)类似物进行抗病毒治疗的103例低HBsAg水平乙肝患者为研究对象,根据PEG-IFNα-2b治疗期间患者TSH水平,分为TSH升高组、TSH正常组、TSH降低组。收集各组患者一般资料及实验室指标,分析HBsAg水平差异。结果各组患者基线性别、年龄、WBC、Hb、PLT、HBsAg、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH比较差异无统计学意义(P>0.05)。各组患者治疗24、48周HBsAg水平和治疗24周HBsAg下降程度比较差异有统计学意义(P<0.05)。TSH降低组治疗24、48周HBsAg水平明显低于TSH正常组,治疗24周HBsAg下降程度明显高于TSH正常组,差异有统计学意义(P<0.05)。结论PEG-IFNα-2b在低HBsAg水平乙肝患者TSH降低(甲状腺功能亢进/亚临床甲状腺功能亢进)中的抗病毒疗效更好。

Objective To investigate the relationship between hepatitis B(HB)surface antigen(HBsAg)and thyroid-stimulating hormone(TSH)during pegylated interferonα-2b(PEG-IFNα-2b)treatment in the HB patients with low HBsAg level.Methods A total of 103 HB patients with low HBsAg level conducting PEG-IFNα-2b combined with nucleos(t)ide analogues antiviral treatment in this hospital during 2020-2022 were selected as the study subjects and divided into the TSH increase group,TSH normal group and TSH decrease group according to the TSH level of the patients during PEG-IFNα-2b treatment.The general data and laboratory indexes in various groups were collected.The differences in HBsAg levels were analyzed.Results There were no statistically significant differences in baseline gender,age,WBC,Hb,PLT,HBsAg,total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4)and TSH among the groups(P>0.05).There were statistically significant differences in the level of HBsAg between 24-week treatment and 48-week treatment and the degree of HBsAg decrease at 24-week treatment among the groups(P<0.05).The HBsAg level after 24-week,48-week treatment in the TSH decrease group was significantly lower than that in the normal TSH group,and the decrease degree of HBsAg at 24-week treatment was significantly higher than that in the normal TSH group,and the differences were statistically significant(P<0.05).Conclusion PEG-IFN-α-2b has better antiviral efficacy for TSH decrease(hyperthyroidism/subclinical hyperthyroidism)in the patients with HBsAg low level hepatitis B.