摘要
目的 探讨初诊Graves甲状腺功能亢进症（简称甲亢）合并肝损害的发生率、临床特点及其相关因素.方法 回顾性分析初诊Graves甲亢患者204例,根据肝功能是否异常分为肝损害组146例和正常组58例.比较两组患者性别组成、年龄、甲状腺质量、病程、24 h摄131I率、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素受体抗体（TRAb）、甲状腺过氧化物酶抗体（TPOAb）及甲状腺球蛋白抗体（TGAb）之间的差异,并对肝功能指标与甲状腺激素进行相关性分析.结果 ①初诊Graves甲亢合并肝损害（至少有一项肝功能指标异常）的发生率为71.6％,以谷丙转氨酶（ALT）异常最常见,发生率为37.7％；肝损害组中仅一项指标异常者61例（41.8％）,以碱性磷酸酶（ALP）异常最常见,占50.8％（31/61）.②肝损害组较正常组病程长,血FT3、FT4及TRAb水平明显增高,而两组间性别组成、年龄、甲状腺质量、24 h摄131I率、TPOAb、TGAb比较差异无统计学意义.③谷草转氨酶与FT3,ALP与FT3、FT4,总胆红素与FT4,直接胆红素与FT3、FT4均呈正相关.结论 初诊Graves甲亢合并肝损害的发生率较高,肝损害最常见的指标包括ALT、ALP水平异常,其发生与甲亢病程、甲状腺激素及TRAb水平密切相关.
Objective To investigate the incidence,clinical features and the possible risk factors of hepatic dysfunction in the newly diagnosed patients with Graves hyperthyroidism.Methods A retrospective analysis about total 204 newly diagnosed patients with Graves hyperthyroidism was studied.All the patients were divided into two groups by liver function：the hepatic dysfunction group （146 cases）and the normal group （58 cases）.The gender composition,age,thyroid weight,24 h-131I intake rate,free triiodothyronine （FT3）,free thyronine （FT4）,thyroid-stimulating hormone receptor antibody （TRAb）,thyroid peroxidase antibodies （TPOAb）and thyroglobulin antibody （TGAb）were compared between the two groups.A correlation analysis was progressed between the indicators of liver function and thyroid hormone.Results ①The incidence of hepatic dysfunction （at least one abnormal parameter）in the newly diagnosed patients with Graves hyperthyroidism was 71.6％ and the most familiar abnormal parameter was alanine transaminase （ALT） （37.7 ％）.Altogether 61 patients （41.8 ％）had only one abnormal parameter in the hepatic dysfunction group and the most common abnormal parameter was alkaline phosphatase （ALP）（50.8％）.②Compared with the normal group,hepatic dysfunction group had longer disease duration,higher serum FT3,FT4 and TRAb levels,but there were no significant differences in gender composition,age,thyroid weight,24 h-1nI intake rate,TPOAb,TGAb between the two groups.③A significantly positive correlation was found between the aspartate aminotransferase and FT3,the ALP and FT3,FT4,the total bilirubin and FT4,the direct bilirubin and FT3,FT4,respectively.Conclusions Hepatic dysfunction in newly diagnosed patients with Graves hyperthyroidism is very common and the most common abnormal parameters include ALT and ALP.The hepatic dysfunction is closely correlated with patients＇ disease duration,thyroid hormone and TRAb levels.
出处
《国际放射医学核医学杂志》
2013年第5期283-286,共4页
International Journal of Radiation Medicine and Nuclear Medicine
