摘要
目的 探讨慢性病毒性肝炎患者干扰素治疗后致甲状腺功能异常的临床特征及其相关危险因素.方法 回顾性分析干扰素治疗的96例慢性病毒性肝炎患者的临床资料,观察甲状腺功能的血清学指标及甲状腺自身抗体变化,治疗结束后继续随访1年,采用Logistic回归分析甲状腺功能异常发生的相关危险因素.结果 96例患者中,干扰素治疗后未发生甲状腺功能异常84例（正常组）;发生甲状腺功能异常12例（异常组）,发生率为12.5％（12/96）,依次为桥本甲状腺炎5例,Graves病和破坏性甲状腺炎各3例,非自身免疫性甲状腺功能减退1例.治疗后发生甲状腺功能异常的时间为2 ～ 7（3.8±1.9）个月,甲状腺功能异常持续时间l～ 11（4.2±0.9）个月.5例进行内分泌治疗,2例停用干扰素.治疗结束后随访1年,所有患者甲状腺功能均恢复正常.Logistic多元回归分析结果显示,女性（OR=3.767）和抗甲状腺过氧化物酶抗体（OR=1.117）是发生甲状腺功能异常的独立危险因素.结论 慢性病毒性肝炎患者干扰素治疗后致甲状腺功能异常以桥本甲状腺炎、Graves病、破坏性甲状腺炎和非自身免疫性甲状腺功能减退为主要类型.接受干扰素治疗的慢性病毒性肝炎患者在治疗过程中均应密切监测甲状腺功能及甲状腺自身抗体,尤其是女性及已有甲状腺自身抗体者.
Objective To investigate the characteristics and risk factors of thyroid dysfunction induced after interferon therapy in patients with chronic viral hepatitis.Methods The clinical data of 96 chronic viral hepatitis patients received interferon therapy were analyzed retrospectively.Serological markers of thyroid function and thyroid autoantibodies changes were observed,and were followed up for 1 year after treatment.Logistic regression analysis was performed to evaluate risk factors of thyroid dysfunction.Results Among the 96 cases,84 cases didn＇t develop thyroid dysfunction after interferon therapy（normal group）,and 12 cases developed thyroid dysfunction after interferon therapy （abnormal group）,the incidence was 12.5% （12/96）,there were 5 cases of Hashimoto＇s thyroiditis,3 cases of Graves disease,3 cases of destructive thyroiditis,and 1 case of non-autoimmune hypothyroidism.The time to develop thyroid dysfunction was 2-7 （3.8 ± 1.9） months after treatment,the duration of thyroid dysfunction was 1-11 （4.2 ± 0.9） months.Five patients received endocrine therapy,and 2 patients stopped interferon therapy.All patients regained normal thyroid function during 1-year followup after end of treatment.Multivariate Logistic regression analysis showed that female gender （OR =3.767） and anti-thyroid peroxidase antibodies （OR =1.117） were the independent risk factors for thyoid dysfunction.Conclusions Hashimoto＇s thyroiditis,Graves disease,destructive thyroiditis and non-autoimmune hypothyroidism are the main types of thyroid dysfunction induced after interferon therapy in patients with chronic viral hepatitis.The thyroid function and thyroid autoantibodies should be closely monitored during treatment in patients with chronic viral hepatitis receiving interferon therapy,especially in female and patients who have thyroid autoantibodies.
出处
《中国医师进修杂志》
2014年第16期43-46,共4页
Chinese Journal of Postgraduates of Medicine
关键词
肝炎
病毒性
人
甲状腺疾病
干扰素Α
危险因素
Hepatitis, viral, human
Thyroid diseases
Interferon-alpha
Risk factors
