摘要
目的探讨初诊Graves病患者甲亢性肝损伤的临床情况及危险因素。方法收集2017年1月至2022年1月于青岛大学附属医院初次诊断为Graves病患者的一般临床资料及实验室检查结果,包括性别、年龄、Graves病病程、吸烟史、饮酒史、家族史、既往疾病史、甲状腺功能及抗体水平、肝功能指标,分析初诊Graves病患者甲亢性肝损伤的危险因素。采用独立样本t检验、χ2检验及多因素logistic回归分析对数据进行分析。结果共收集患者261例,其中男66例,女195例;年龄(38.63±12.68)岁。初诊Graves病患者甲亢性肝损伤的发生率为45.59%,最常见的肝功能异常为丙氨酸氨基转移酶(ALT)升高(29.89%)。依据患者是否存在甲亢性肝损伤进行分组,其中肝功能正常组142例,肝功能异常组119例。单因素结果分析显示,肝功能异常组的年龄、女性比例、新发房颤比率、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、甲状腺过氧化物酶抗体(TPOAb)、促甲状腺受体抗体(TRAb)水平高于肝功能正常组,差异有统计学意义(P<0.05);两组的Graves病病程、吸烟史、饮酒史、家族史、糖尿病史、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)比较,差异无统计学意义(P>0.05)。logistic回归模型多因素分析结果显示,年龄(β=0.039,OR=1.040,95%CI:1.016~1.065)、FT_(4)(β=0.019,OR=1.019,95%CI:1.019~1.003)、TPOAb(β=0.006,OR=1.006,95%CI:1.004~1.009)、TRAb(β=0.030,OR=1.031,95%CI:1.001~1.061)是初诊Graves病患者甲亢性肝损伤的独立危险因素。结论在初诊Graves病患者中,年龄大,FT_(4)、TPOAb、TRAb水平高的患者更易出现甲亢性肝损伤。
Objective To investigate the clinical situation and risk factors of hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease.Methods The general clinical data and laboratory test results of patients with Graves disease initially diagnosed in Affiliated Hospital of Qingdao University from January 2017 to January 2022 were collected,including gender,age,course of Graves disease,smoking history,drinking history,family history,past disease history,thyroid function and antibody levels,and liver function were used,the risk factors of hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease was compared.Data analysis was performed using independent samples t test,chi-square test,and multivariate Logistic regression analysis.Results A total of 261 patients were collected,included 66 males and 195 females,with an average age of(38.63±12.68)years.The incidence of hyperthyroidism-induced liver injury in newly diagnosed Graves disease patients was 45.59%,and the most common abnormal liver function was elevated alanine aminotransferase(ALT),which accounted for 29.89%.According to whether the patients had hyperthyroidism liver injury or not,there were 142 cases in the normal liver function group and 119 cases in the abnormal liver function group.Univariate analysis showed that the age,female proportion,new atrial fibrillation rate,free triiodothyronine 3(FT_(3)),free tyroxine 4(FT_(4)),thyroid peroxidase antibody(TPOAb),thyrotropin receptor antibody(TRAb)levels in the abnormal liver function group were higher than those in the normal liver function group,and the differences were statistically significant(P<0.05).There were no significant differences in the course of Graves'disease,smoking history,drinking history,family history,diabetes history,the levels of thyroid stimulating hormone(TSH)and thyroglobulin antibody(TGAb)between the two groups(P>0.05).The Logistic regression model showed that the results of multivariate analysis showed that age(β=0.039,OR=1.040,95%CI:1.016-1.065),FT_(4)(β=0.019,OR=1.019,95%CI:1.019-1.003),TPOAb(β=0.006,OR=1.006,95%CI:1.004-1.009),TRAb(β=0.030,OR=1.031,95%CI:1.001-1.061)were an independent risk factor for hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease.Conclusion Among the newly diagnosed patients with Graves disease,those with older age and higher levels of FT_(4),TPOAb and TRAb are more likely to develop hyperthyroidism-induced liver injury.
作者
赵娜
耿凡琪
陈瞳
赵天
毕小雯
张杰涛
ZHAO Na;GENG Fanqi;CHEN Tong;ZHAO Tian;BI Xiaowen;ZHANG Jietao(Department of General Medicine,Affiliated Hospital of Qingdao University,Shandong Province,Qingdao 266000,China)
出处
《中国当代医药》
CAS
2023年第20期110-113,共4页
China Modern Medicine
关键词
GRAVES病
甲亢性肝损伤
甲状腺功能
危险因素
Graves disease
Hyperthyroidism-induced liver injury
Thyroid function
Risk factors
