血清甲状腺激素水平与肝硬化类型的相关性研究

目的 探讨不同类型肝硬化患者血清甲状腺激素水平的改变情况。方法 选择2010年1月至2013年6月本院住院治疗的原发性胆汁性肝硬化（PBC）、酒精性肝硬化和病毒性肝炎后肝硬化患者共84例,回顾性统计患者血清甲状腺激素和总胆红素检测结果。结果 84例患者根据疾病类型分为PBC组17例、酒精性肝硬化组25例、病毒性肝炎后肝硬化组42例。3组患者血清总三碘甲状腺原氨酸（TT3）和血清总甲状腺素（TT4）均降低,且3组患者间差异有显著统计学意义（P〈0.001和P=0.001）,其中以PBC患者外周血TT3水平最低,酒精性肝硬化患者外周血TT4水平最低。相对于无黄疸患者,有黄疸的肝硬化患者血清游离三碘甲状腺原氨酸（FT3）和TT3水平下降明显,差异均有统计学意义（P〈0.001和P=0.001）。结论 肝硬化患者多存在甲状腺激素水平的异常改变,且不同类型肝硬化患者血清甲状腺激素改变可能存在差异。

Observation of serum thyroid hormone levels in patients with different types of cirrhosis

Objective To analyze the serum thyroid hormone levels in patients with different types of cirrhosis. Methods Retrospective analysis of 84 cases between January 2010 and June 2013, primary biliary cirrhosis （PBC）, alcoholic cirrhosis and viral decompensented cirrhosis patients with serum thyroid hormone and total bilirubin detection results. Results Eighty four patients were divided into PBC group of 17 cases, alcoholic cirrhosis group of 25 cases, viral decompensented cirrhosis group of 42 cases depending on the type of disease. The serum levels of total triiodothyronine （TT3） and serum total thyroxine （TT4） were decreased in all three types of cirrhosis, and the differences among the three groups was also statistically significant （P 〈 0.001 and P = 0.001）. Among them, patients with PBC had the lowest levels of TT3, while patients with alcoholic cirrhosis had the lowest levels of TT4. As compared to cirrhotic patients without jaundice, the serum levels of free triiodothyronine （FT3） and TT3 were decreased significantly in cirrhotic patients with jaundice （P 〈 0.001 and P = 0.001）. Conclusions Abnormal changes of thyroid hormone levels are common in cirrhotic patients, and the levels of serum thyroid hormone may vary in different types of cirrhosis.