摘要
目的观察甲状腺功能亢进症初诊患者中伴发肝功能损害的发病情况及影响因素,并探讨内科治疗及预后。方法甲亢初诊患者192例,筛查出合并肝功能异常者80例,保肝药物治疗同时给予抗甲状腺药物甲巯咪唑15mg,每日1次,口服,分别于治疗后第4周、第8周和第12周进行随访。结果 1)甲亢初诊患者合并肝功能异常的发生率为41.7%。2)肝功能异常患者中71.3%为碱性磷酸酶升高最为多见,35.0%患者丙氨酸转氨酶升高,28.8%患者谷草转氨酶升高。3)Logistic多因素回归显示,2倍以上升高的FT3(OR=5.178)或FT4(OR=7.764)是肝功能异常的独立危险因素。性别、年龄、TPOAb及TgAb对肝功能无影响。4)治疗4周、8周和12周后,甲状腺功能恢复正常的比例分别为67.1%、85.5%和89.5%。肝功能恢复正常的比例分别为78.9%、81.6%和88.2%。结论甲亢性肝功能异常发病率高,明显升高的甲状腺激素与肝功能损害相关,但经内科药物治疗预后良好。
Objective To investigat the clinical characteristics,as well as to explore therapentic measures for newly diag- nosed hyperthyroid patients with hepatic dysfunction. Methods Clinical records of 192patients with Graves disease were studied. A follow-up study was performed after antithyroid drugs and protecting-liver treatment at 4,8 and 12week. Results （1） The prevalence of hepatic dysfunction in newly diagnosed Graves disease patients was 41.7 % （80 cases）. （2）Increased ALP was the most familiar abnormal hepatic function parameter （71.3%）. The rate of increased ALT was 35.0% and that of AST was 28.8%. （ 3 ） Logistic regression analysis showed that more than twice of FT3 （ OR = 5. 178 ） or FT4 （ OR = 7. 764） was the independent predictor of hepatic dysfunction. The data wese not able to show statistic significance in sex, age, TPOAb and TgAb. （4）Among 76 patients who accepted the follow-up study,60 subjects ,62subjects and 70 subjects （78.9% ,81.6% and 88.2% ） had resumed normal liver function test at 4,8 and 12 week respectively. Conclusions Patients with hyperthyroid- ism are susceptible to hepatic dysfunction and markedly higher level of thyroid hormone are associated to liver injury. Antithyroid drugs and protecting-liver treatment are effective in treating hepatic dysfunction caused by thyrotoxicosis.
出处
《辽宁医学杂志》
2014年第4期179-181,共3页
Medical Journal of Liaoning
