糖尿病血清甲状腺激素水平的变化及其临床意义

对糖尿病患者171例、正常健康成人30例,采用放射免疫分析法测定其甲状腺激素水平.结果糖尿病患者血清总T3(TT3)、总T4(TT4)、游离T3(FT3)、游离T4(FT4)水平均显著低于正常对照组(P值均＜0.01),血清TSH水平无明显变化,rT3水平显著升高,(P＜0.05).结论糖尿病患者血清TH水平下降,rT3升高,TSH无变化对其甲状腺功能的评价具有重要意义.     

老年心脏病患者低T3综合征与甲减的鉴别

目的 探讨老年心脏病患者低T3综合征与甲减的鉴别.方法 研究对象为88例老年心脏病患者低T3综合征、46例原发性甲状腺功能减退症(甲减)及同期来我院体检的46例正常老年人,用放射免疫分析法分别测定各组血清中甲状腺激素(TH)水平,并对检测结果 进行对比分析.结果 (1)甲减组血清中TT4、FT4、rT3含量低于低T3综合征组(P＜0.01),sTSH含量高于低T3综合征组(P＜0.01),统计学有显著性差异.(2)死亡组血清中TT3、FT3、FT4、sTSH的含量均低于存活组(P＜0.05),rT3的含量高于存活组(P＜0.05),统计学有显著性差异;两组TT4值比较,统计学有非常显著性差异 (P＜0.001).结论 老年心脏病患者低T3综合征可帮助临床判断老年心脏病患者的病情严重程度,并有助于预后的判断.根据低T3综合征与甲减的TH水平特点,可有助于鉴别此两种疾病,从而减少误诊率.     

急性心肌梗死患者血清甲状腺激素水平及临床意义

目的 观察急性心肌梗死(AMI)患者血清甲状腺激素水平及临床意义。方法采用放射免疫分析法(RIA)对43例AMI患者治疗前后及40例正常对照者测定甲状腺激素水平。结果 AMI患者治疗前与正常对照组比较无论心力衰竭组或无心力衰竭组T3水平明显降低,rT3明显升高,尤以心力衰竭组T3、rT3改变更为显著,而T4及TSH无明显改变,AMI治疗后与治疗前比较T3明显升高.rT3明显下降。结论 血清T3及rT3水平变化对AMI患者病情及预后的判断有一定的临床价值。     

慢性充血性心力衰竭患者甲状腺激素含量变化的意义

目的探讨慢性充血性心力衰竭(CHF)患者血清甲状腺激素水平及其临床意义。方法分别测定72例CHF患者治疗前后及30例健康人群的血清甲状腺激素水平,并进行对比观察。结果 CHF患者的T3水平和T3/rT3比值明显低于健康对照组((P0.01),而rT3和T4水平与健康对照组比无明显差别(P0.05)。随心功能不全加重,患者的T3,T3/rT3比值逐渐降低,rT3升高,心功能IV级和死亡患者T4水平也明显降低。随病程延长,T3水平降低。结论 CHF患者检测T3,rT3和T4水平有助于心功能状态,疗效和预后的判断。     

充血性心力衰竭患者甲状腺激素变化的临床意义

为探讨充血性心力衰竭（CHF）患者甲状腺激素异常变化的临床意义，对33例CHF及15例正常人血清甲状腺激素水平进行测定。结果表明：CHF组三碘甲状腺原氨酸（T3）、反三碘甲状腺原氨酸（rT3）与对照组比较有显著差异（P＜0．05），CHF组随着病情加重，T3逐渐降低，rT3逐渐增高；总甲状腺素及促甲状腺激素无明显改变。血清T3及rT3的改变可作为判断CHF严重程度的指标。     

健康高龄老年人甲状腺激素水平变化趋势分析

目的 探讨80岁以上高龄老年人甲状腺激素水平变化趋势.方法 将602例健康志愿者按年龄分为中青年组(20～59岁)226例、老年组(60～79岁)195例和高龄组(80～102岁)181例,采用化学发光法及放射免疫法测定志愿者血清三碘甲状腺原氨酸(TT3)、甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、反T3(rT3)水平,并以SPSS 13.0进行统计分析.结果 老年组与中青年组比较,血清FT3和TT3降低,差异有统计学意义(t值分别为2.793和3.627,均为P＜0.01);高龄组与中青年组比较,TT3、TT4、FT3、TSH、rT3浓度差异有统计学意义(t值分别为10.930、6.065、15.398、-2.933、-5.643,均为P＜0.01);老年组与高龄组比较,TT3、TT4、FT3、TSH、rT3浓度差异有统计学意义(t值分别为8.382、4.298、11.573、-3.383、-5.148,均为P＜0.01).FT3、TT3、TT4浓度与年龄呈负相关(r值分别为-0.51、-0.39、-0.25,P＜0.01),rT3、TSH浓度与年龄呈正相关(r值分别为0.32、0.12,P＜0.01),FT4与年龄无相关.高龄组高于或低于临床正常参考值范围的阳性发生率,在TT3、TT4、FT3、FT4、TSH、rT3中分别为0、0、13.8%、0、6.6%、21%.结论 随着年龄增长,老年人血清甲状腺激素水平及促甲状腺激素均有改变,特别是80岁及以上高龄老年人,血清FT3、rT3、TSH变化更为明显,建议临床设立老年人不同年龄段的血清甲状腺激素正常参考值范围,以减少假阳性的发生率.

Abstract：

Objective To explore the variation tendency of serum thyroid hormone level in the elderly aged over 80 years.Methods The 602 healthy volunteers were divided into 3 groups by age:young group (20-59 years of age,n= 226),elderly group (60-79 years of age,n= 195),and advanced age group (80-102 years of age,n=181).Fasting blood of all persons was harvested,then the levels of serum total triiodothyroxine (TT3),total thyroxine (TT4),free tri-iodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH) and reverse tri-iodothyronine (rT3) were determined by chemistry luminescence technique and radioimmunoassay.Statistical analysis was made by the software SPSS 13.0.Results The levels of serum FT3 and TT3 were lower in elderly group than in young group (t=2.793,3.627,P=0.005,0.000).There were significant differences in the levels of serum TT3,TT4,FT3,TSH and rT3 between young group and advanced-age group (t =10.930,6.065,15.398,- 2.933,- 5.643,all P = 0.000),also between elderly group and advanced-age group (t= 8.382,4.298,11.573,-3.383,-5.148,all P＜0.001).The levels of serum FT3,TT3 and TT4 were negatively correlated with age (r=- 0.51,-0.39 and -0.25,respectively,all P＜0.01).And the levels of serum rT3 and TSH showed positive relationships with age (r=0.32,0.12,all P＜0.01).There were no relationships between the level of serum FT4 and age.The positive rate of serum TT3,TT4,FT3,FT4,TSH and rT3 concentration beyond the reference value was 0,0,13.8%,0,6.6% and 21% in advanced-age group,respectively.Conclusions The levels of serum thyroid hormone and thyroid-stimulating hormone change with age.The levels of FT3,rT3 and TSH change obviously in the elderly aged over 80 years.It could reduce the false positive rate in clinical practice if normal reference range for serum thyroid hormone levels in different aged elderly is established.     

轻度认知障碍和阿尔茨海默病患者血脂及甲状腺激素水平的关系

目的 探讨轻度认知障碍(MCI)和阿尔茨海默病(AD)与血脂水平、甲状腺功能的关系.方法 对39例MCI、43例AD和46例对照组血清血脂、甲状腺激素水平进行测定,并进行组间对比研究.结果 MCI组血清总胆崮醇(TC)水平显著高于对照组(P＜0.05),且AD组增高更明显(P＜0.01);MCI组和AD组血清低密度脂蛋白胆固醇(LDL-C)水平均比对照组显著增高(P＜0.01).MCI组血清T4水平显著低于对照组(P＜0.05),且AD组降低更明显(P＜0.01);MCI组和AD组F13水平均显著低于对照组(P＜0.01).结论 血清TC、LDL-C增高及血清T4、FT3水平降低与MCI和AD的发病有关,降脂及维持甲状腺功能的正常可能对防治MCI和AD有一定作用.     

老年巨幼细胞性贫血患者血清甲状腺激素水平的变化及意义

目的探讨甲状腺激素水平在老年巨幼细胞性贫血患者中的变化及意义。方法用放射免疫分析法测定了38例老年巨幼细胞性贫血患者治疗前及缓解后和20例正常老年人血清FT3、FT4、TSH、rT3水平的变化并对数据进行统计学分析。结果老年巨幼细胞性贫血患者治疗前血清FT3、FT4水平明显降低,rT3明显增高,与对照组比较有显著性差异(P<0.01),但TSH值两组间对比无明显差异。治疗后缓解组血清FT3,、FT4水平和rT3恢复正常,与对照组比较差异无显著性。结论老年巨幼细胞性贫血患者存在着血清甲状腺水平的异常,其甲状腺激素水平的测定有助于判断病情及估计预后。     

脑出血病人血清甲状腺激素的变化及临床意义

目的探讨急性脑出血时甲状腺激素水平的变化与疾病预后的关系。方法观察32例急性脑出血病人24h内及发病4周以后的甲状腺激素的水平变化,并与正常对照组作比较,分析其临床意义。结果脑出血组的T3明显低于对照组,rT3则明显高于对照组（P〈0.01）。随着病情的好转,T3、FT3都有所回升,高rT3有所下降。结论血清甲状腺激素变化的程度与疾病的危重程度是密切相关的。     

重型病毒性肝炎患者生长激素-胰岛素样生长因子轴的临床研究

目的研究重型病毒性肝炎患者GH-IGF轴的变化及其临床意义。方法重型病毒性肝炎患者18例,其中急性重型2例,亚急性重型5例,慢性重型11例;正常对照20例。ELISA法测定血清GH、IGF-1、IGFBP1及IGFBP3,全自动生物化学分析仪常规方法测定肝脏生物化学指标。结果重型肝炎患者血清IGF-1、IGFBP3水平明显降低［(5.5±6.2)μg/ml对(17.6±7.0)μg/ml,(2.4±1.3)μg/ml对(9.4±1.7),P＜0.001］。GH、IGFBP1水平增高［(9.1±12.4)ng/ml对(1.6±2.4)ng/ml,P＜0.05;(67.9±50.2)ng/ml对(45.8±33.1)ng/ml,P＜0.01)］。血清IGF-1与IGFBP3呈正相关(r＝0.91,P＜0.001);IGF-1降低与重型肝炎患者预后密切相关(P＜0.001)。IGF-1＜10μg/ml,预测死亡的符合率为90%;IGF-1＞10μg/ml,预测存活的符合率为89.5%。结论重型病毒性肝炎患者GH-IGF轴发生显著异常变化,GH增高与IGF-1水平降低相矛盾,提示重型病毒性肝炎患者存在生长激素抵抗。血清IGF-1水平可作为预测重型肝炎患者预后的指标。     

老年非甲状腺疾病患者甲状腺功能检测及评价

本文对老年非甲状腺疾病患者107例、健康老年人30例的血清T_3、T_4、FT_3、FT_4、γT_3、TSH水平进行测定。结果表明,老年心血管疾病、恶性肿瘤、肺部疾病、糖尿病、肝病患者T_3明显降低(P<0.05),FT_3显著降低(P<0.01),γT_3显著增高(P<0.01)。老年其他疾病(神经系疾病、胆囊炎等)T_3虽无明显变化,但FT_3仍明显降低(P<0.05)。T_4仅在肺部疾病患者明显降低(P<0.05),其余各组T_4、FT_4、TSH均无显著改变,健康老年T_3较健康成年人明显降低(P<0.05),其变化程度与疾病严重程度有一定关系,其中以FT_3更为敏感。故认为,测定甲状腺激素水平对判断老年患者病情、估计预后有重要参考价值。     

Serum thyroid hormone levels in patients with liver disease.

Levels of serum triiodothyronine (T3), reverse triiodothyronine (rT3), and thyroxine (T4) were determined in 29 patients with alcoholic cirrhosis, seven patients with acute hepatitis, and 14 control patients hospitalized for chronic disease. Serum T3 levels were decreased significantly and serum rT3 levels increased significantly in the patients with alcoholic cirrhosis. Serum T3 and T4 levels were lower and rT3 levels higher in the cirrhotic patients who died within three months of the study compared with those who survived. A combination of prothrombin time, aminopyrine breath test results, and rT3 and T3 determinations gave significant predictive information about survival in patients with cirrhosis. The data suggest that assay of serum thyroid hormone levels together with prothrombin time and the aminopyrine breath test may be helpful in assessing the course and prognosis of patients with liver disease.     

血清甲状腺激素水平对肝硬化患者C型肝性脑病评估的临床意义

目的探讨血清甲状腺激素水平对肝硬化患者C型肝性脑病(HE)评估的临床意义。方法对60例C型HE和120例无HE的肝硬化患者以及50例健康体检者进行血清总甲状腺素(T4)、血清总三碘甲状腺原氨酸(T3)、血清游离甲状腺素(FT4)、血清游离三碘甲状腺原氨酸(FT3)和促甲状腺素(TSH)检测,比较并分析肝硬化患者与健康体检者间甲状腺功能差异;比较60例C型HE各期(0、Ⅰ、Ⅱ、Ⅲ和Ⅳ期)之间甲状腺功能水平。统计学处理采用t检验、方差分析及x~2检验。结果肝硬化组与健康对照组间甲状腺功能比较,差异有统计学意义(P<.111),并与Child-Pugh分级有密切相关性;HE组与无HE组甲状腺功能有明显差异,TSH分别为(13.65±3.12)μU/mL、(9.26±1.86)μU/mL(P<0.01);T3分别为(0.87±0.12)nmol/L、(1.21±0.33)nmol/L(P<0.01);且在同一Child-Pugh分级,HE组与无HE组甲状腺功能亦有差异。HE不同分期甲状腺功能差异具有统计学意义(P<0.01),Ⅲ、Ⅳ期与Ⅰ、Ⅱ期组比较,差异有统计学意义(P<0.01)。入院时为Ⅲ、Ⅳ期患者与入院时为Ⅰ、Ⅱ期患者的预后差异有统计学意义(P<0.01)。结论甲状腺功能低下可能对HE的发生、发展有一定影响;甲状腺功能亦可能是影响HE预后的重要因素之一。     

血清甲状腺素水平对C型肝性脑病评估的临床意义

目的探讨血清甲状腺素水平对于C型肝性脑病（HE）评估的临床意义。方法对80例C型HE和150例无HE的肝硬化患者进行甲状腺功能检测（T4、T3、FT4、FT3、TSH）,比较并分析两组患者甲状腺功能差异;比较80例C型HE各期（0、I、II、III、IV）之间甲状腺功能水平。结果肝硬化组与正常对照组间甲状腺功能差异具有统计学意义（P〈0.01）,并与Child-Pugh分级有密切相关性;HE组与无HE组甲状腺功能有明显差异[TSH（13.45±3.15）vs（9.15±2.65）,P〈0.01;T3（0.67±0.21）vs（1.21±0.37）,P〈0.01];且在同一Child-Pugh分级,HE组与无HE组甲状腺功能亦有差异。HE不同分期甲状腺功能差异具有统计学意义（P〈0.01）,III、IV期与I、II期组比较,差异具有统计学意义（P〈0.01）。入院时为III、IV期患者与入院时为I、II期患者的预后差别有统计学意义（P〈0.01）。结论甲状腺功能低下可能对HE的发生发展有一定影响;甲状腺功能亦可能是影响HE预后的重要因素之一。     

Serum 3,3',5'-triiodothyronine (rT3) and 3,5,3'-triiodothyronine/rT3 are prognostic markers in critically ill patients and are associated with postmortem tissue deiodinase activities

INTRODUCTION AND METHODS: Critical illness is associated with reduced TSH and thyroid hormone secretion, and with changes in peripheral thyroid hormone metabolism, resulting in low serum T3 and high rT3. In 451 critically ill patients who received intensive care for more than 5 d, serum thyroid parameters were determined on d 1, 5, 15, and last day (LD). All patients had been randomized for intensive or conventional insulin treatment. Seventy-one patients died, and postmortem liver and skeletal muscle biopsies were obtained from 50 of them for analysis of deiodinase (D1-3) activities. RESULTS: Insulin treatment did not affect thyroid parameters. On d 1, rT3 was higher and T3/rT3 was lower in nonsurvivors as compared with survivors (P = 0.001). Odds ratio for survival of the highest vs. the lowest quartile was 0.3 for rT3 and 2.9 for T3/rT3. TSH, T4, and T3 were lower in nonsurvivors from d 5 until LD (P < 0.001). TSH, T4, T3, and T3/rT3 increased over time in survivors, but decreased or remained unaltered in nonsurvivors. Liver D1 activity was positively correlated with LD serum T3/rT3 (R = 0.83, P < 0.001) and negatively correlated with rT3 (R = -0.69, P < 0.001). Both liver and skeletal muscle D3 activity were positively correlated with LD serum rT3 (R = 0.32, P = 0.02 and R = 0.31, P = 0.03). CONCLUSION: In critically ill patients who required more than 5 d of intensive care, rT3 and T3/rT3 were already prognostic for survival on d 1. On d 5, T4, T3, but also TSH levels are higher in patients who will survive. Serum rT3 and T3/rT3 were correlated with postmortem tissue deiodinase activities.     

Serum free thyroid hormones and response of TSH to TRH in nonthyroidal illnesses

The change in the levels of free thyroid hormones and the pathophysiology of the hypothalamo-pituitary-thyroid axis of patients with nonthyroidal illness (NTI) have not been clearly elucidated so far. Therefore, it was thought of interest to investigate this problem by determining free thyroid hormones and TSH in serum and the response of TSH to TRH in these patients. The subjects employed in this study were 71 cases with hemodialysis, 40 cases with diabetes mellitus, 24 cases with liver cirrhosis, 12 cases with various cancers, 10 cases with anorexia nervosa and 110 normal subjects as controls. The serum total protein, albumin, free T4, free T3, TSH and other parameters of thyroid function were determined, and the TRH test was performed on about 10 patients of each group. Serum TSH was not only determined by a conventional assay system, but with a highly sensitive method, and the data were compared with one another. It was found that the serum free T3 levels were significantly low in all the groups investigated, but the serum free T4 levels were significantly low only in the groups with hemodialysis, decompensated liver cirrhosis, cancers and anorexia nervosa. No significant lowering of serum free T4 was observed in the patients with diabetes mellitus, acute hepatitis and compensated liver cirrhosis. However, serum TSH levels tended to be higher in all the groups studied, though they were not significant. The response of TSH to TRH was low or delayed in about 20-50% of patients with hemodialysis, diabetes mellitus, liver cirrhosis, cancers and anorexia nervosa. It was observed that the serum rT3 concentration was significantly high in the patients with diabetes mellitus and anorexia nervosa but significantly low in the patients on hemodialysis. In the rest of the groups, there were found many cases who showed high levels of serum rT3 although they were not statistically significant. These results indicate that low concentrations of serum free T3 observed in the majority of the patients with severe NTI were, at least in part, due to the decrease in the peripheral conversion of T4 to T3 and the lowered sensitivity of the anterior pituitary to thyroid hormones and TRH.     

乙型肝炎患者血清免疫抑制酸性蛋白的变化及临床意义

探讨免疫抑制酸性蛋白(IAP)在乙型肝炎中的变化规律及其临床意义。采用单向免疫扩散法检测血清IAP。同时检测血清总胆红素(TB il)和凝血酶原活动度(PTA)。慢性乙肝患者和慢性重型乙肝组IAP明显降低,与正常对照组比较差异有显著性(t=3.38,P<0.01;t=6.55,P<0.01);慢性乙肝和慢性重型乙肝组两组之间IAP比较亦有显著性差异(t=3.99,P<0.05)。与存活组相比,死亡组的PTA值、IAP明显降低,TB il显著增高,差异有显著性。血清IAP水平与TB il呈显著负相关(r=-0.359,P<0.01),与PTA呈显著正相关(r=0.389,P<0.01)。IAP值可反映肝细胞受损的严重程度。血清IAP的检测对评估乙肝患者肝功能损害的严重程度和判断预后具有重要的参考价值。IAP检测简单方便,临床上可将IAP列为常规生化检查指标。     

血清前白蛋白在肝病中的临床意义

了解病毒性肝炎患者血清前白蛋白 (PA)的变化 ,探讨测定血清前白蛋白对病毒性肝炎患者的诊断价值。采用免疫比浊法检测 2 76例病毒性肝炎患者血清前白蛋白 ,比较不同临床类型的血清PA的水平及同一临床类型间PA与A的异常率。血清PA的水平在急性肝炎与轻度慢性肝炎之间、慢性肝炎轻度与中度、中度与重度之间、肝硬化与慢性重型肝炎之间均有显著性差异 (P <0 0 5 ) ;急性肝炎组PA与白蛋白 (A)两者相比有高度显著性差异 (P <0 0 0 1) ;PA值比A值更灵敏地反映肝功能损害。血清PA的水平持续 <10 0mg/L作为重症肝炎早期诊断指标之一。检测血清PA对病毒性肝炎临床诊断、病情判断和预后估计有一定参考价值     

Increased serum reverse triiodothyronine levels at diagnosis of hepatocellular carcinoma in patients with compensated HCV-related liver cirrhosis

OBJECTIVE: The aim of this study was to investigate changes in thyroid hormone metabolism in relation to the development of hepatocellular carcinoma (HCC) in patients with HCV-related liver cirrhosis. MATERIALS AND METHODS: The study group (Group A) comprised 31 patients (25 M, 6 F; median age 62.1 years, range 54.0-81.5 years) affected by HCV-related liver cirrhosis with superimposed HCC. Acute and chronic systemic disease, other than cirrhosis, inducing 'euthyroid sick syndrome' was excluded in all patients. Serum TSH, FT4, FT3, rT3, and thyroxine-binding globulin (TBG) levels were retrospectively evaluated in frozen aliquots drawn at the time of tumour diagnosis and every 6 months for 3-7 years before HCC diagnosis. The control group (Group B) comprised 29 patients affected by HCV-related liver cirrhosis without HCC, matched for sex, age and grade of liver dysfunction. RESULTS: At the time of HCC diagnosis, all patients in Group A were euthyroid with serum TSH, FT4, FT3 and TBG values not significantly different from those of cirrhotic patients of Group B. However, at diagnosis Group A patients had serum rT3 values that were significantly higher than those in Group B (35.0 ng/dl, range 12.0-162.0 vs. 19.0 ng/dl, range 10.0-51.0; Group A vs. Group B; P < 0.001). Serum rT3 values above the normal range were found in 12 patients in Group A (38.7%) but in only one of the patients from Group B (3.4%) (chi2 10.2; P = 0.001). The serum rT3 levels were not significantly correlated to the Child grade of liver cirrhosis (rho 0.1; P = 0.5). The intrasubject analysis demonstrated that a significant increase in serum rT3 levels occurred at the time of HCC diagnosis but serum FT4, FT3 and TSH values did not change significantly. A receiver operating curve (ROC) demonstrated that a 6-monthly increase in serum rT3 levels of at least +22.5% identified patients with HCC with a diagnostic accuracy of 81.7%. CONCLUSIONS: Our study has demonstrated that development of hepatocellular carcinoma is accompanied by a significant increase in serum rT3 levels in patients with low-grade HCV-related liver cirrhosis who had no other illness causing the 'euthyroid sick syndrome'.     

Usefulness of serum thyroid-stimulation hormone (TSH) as a prognostic indicator for acute-on-chronic liver failure

Background and rationale for the study. To investigate thyroid function in patients with acute-on-chronic liver failure (ACLF) caused by hepatitis B virus infection and to determine whether thyroid hormone levels can be used as prognostic markers for assessing severity and prognosis of ACLF patients. We enrolled 75 patients with ACLF and70 patients with chronic hepatitis B (CHB).Continual serum samples were collected during hospitalization from the ACLF patients. The serum thyroid hormone levels (triiodothyronine [T3], thyroxine [T4], free (F)-T3, FT4, and thyroid stimulation hormone [TSH]) were measured by chemiluminescence. The Model for End-stage Liver Disease (MELD) score was used to assess severity.Results. ACLF patients showed significantly (p < 0.001) lower values of serum T3, T4, FT3/FT4 and TSH than CHB patients. The T3, T4, and TSH levels in ACLF patients were negatively correlated with the MELD score (T3: r = -0.495, p < 0.001; T4: r = -0.281, p < 0.001; TSH: r = -0.498, p < 0.001), suggesting that serum thyroid hormone levels reflect disease severity. At 1 year, 31 patients died. The T3 (p = 0.016), T4 (p = 0.008), and TSH (p = 0.003) levels in non-survivors were significantly lower than in survivors. The serum TSH level was a significant factor for predicting mortality in ACLF patients (optimal cutoff value = 0.38 IU/mL). The cumulative survival rate was decreased significantly when the serum TSH level was < 0.38 IU/mL (39.2%, p < 0.001).Conclusion. Serum TSH level may be a useful indicator for assessing severity and prognosis in ACLF patients.