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。

Clinical significance of the level of serum thyroxin in type - C HE patients

Objective To investigate the level of serum thyroxin in the type-C hepatic encephalopathy（HE） patients and its clinical significance.Methods The levels of serum thyroxin（T4,T3,FT4,FT3,TSH） were determined by radioimmunoassay in HE patients（80 cases）and non-HE patients（150 cases）.The HE cases were classified into period 0,I,II,III and IV.Results The level of serum thyroxin（T4,T3,FT4,FT3） gradually decreased along with deterioration of hepatocirrhosis while the level of TSH increased.The levels of serum thyroxin were significantly different between HE and non-HE,even in the same stage of Child-pugh.The levels of serum thyroxin were also different among the periods in HE（particularly III,IV vs I,II） Conclusion The disorder of thyroxin levels is probably a significant factor which can affect the development of HE,it can also be one of the important factors that influence the prognosis of HE.