丙型肝炎病毒相关甲状腺功能障碍发病机制与临床治疗研究进展

丙型肝炎病毒（HCV）相关甲状腺功能障碍是慢性丙型肝炎患者的常见并发症,其临床表现包括Graves病、桥本甲状腺炎、破坏性亚急性甲状腺炎、单纯甲状腺功能的亢进或减低,可伴有或不伴有自身抗体或甲状腺相关抗体水平异常.目前学者认为HCV相关甲状腺功能障碍可能的致病机制,包括旁道激活途径、分子模拟机制、干扰素作用以及特殊位点基因多态造成遗传易感性.目前尚缺乏对HCV相关甲状腺功能障碍的规范临床诊疗标准,对于轻症甲状腺功能障碍主要以观察为主,严重者可依据临床表现选择抗甲状腺药物、左旋甲状腺素、手术或对症治疗.该文总结了HCV相关甲状腺功能障碍的流行病学、临床特点以及发病机制,为临床医师的临床诊疗提供依据.

Advances in pathogenesis and management of hepatitis C virus-related thyroid dysfunction

Hepatitis C virus （HCV）-related thyroid dysfunction is a common complication in patients with chronic hepatitis C,including Graves＇ disease,Hashimoto thyroiditis,destructive subacute thyroiditis,hyperparathyroidism or hypothyroidism,with or without abnormal autoantibodies or thyroidrelated antibodies.The possible pathogenesis of HCV-related thyroid dysfunction includes bystander activation,molecular mimicry,effects of interferon and susceptibility associated with genetic polymorphism on particular locus.By now,there is still no criteria for diagnosis and treatment of HCV-related thyroid dysfunction.For patients with mild HCV-related thyroid dysfunction,observation may be appropriate; and for those with serious symptoms,anti-thyroid drug,levothyrocine,surgery or symptomatic treatment may be applied according to clinical symptoms.This paper gives an overview of the prevalence,clinical characteristics and possible pathogenesis of HCV-related thyroid dysfunction.