病毒性肝炎患者血清甲状腺激素检测的临床意义

目的研究病毒性肝炎患者肝功能损害程度与甲状腺激素水平变化的相关性及其临床意义。方法采用化学发光法、酶法和凝固法分别测定病毒性肝炎患者和体检健康者血清T3、T4、FT3、FT4、TSH以及ALT、AST、TBIL、ALB、凝血酶原活动度等,并将肝炎患者进行分组,然后对实验结果进行分析比较。结果轻度肝病患者T3、FT4和中度肝病患者T3、T4均高于健康对照组（P〈0.05）;而重度肝病患者血清T3、FT3水平较轻度和中度患者降低（P〈0.05）;黄疸性慢性肝炎患者血清T3,T4,FT3和TSH水平明显低于非黄疸性慢性肝炎患者（P〈0.01）,慢性肝炎患者血清T3、T4明显高于肝硬化患者（P〈0.05）;另外,肝病患者中好转组T3,T4,FT3,TSH的水平均高于非好转组（P〈0.05）。结论病毒性肝炎患者肝功能的损害程度与其甲状腺激素水平的变化明显相关,肝病患者甲状腺激素水平的监测对肝功能受损导致甲状腺功能紊乱的临床诊治及疗效观察具有重要的实用价值。

The Clinical Significance of Thyroid Hormone Test in Patients with Viral Hepatitis

Objective To study the clinical significance and the correlation of liver damage and thyroid hormone levels in patients with viral hepatitis. Methods The levels of T3,T4,FT3,FT4,TSH,ALT,AST,TBIL,ALB and prothrombin activity in the healthy individual sera and the patients with viral hepatitis sera were tested by Chemiluminescence and GPO-PAP methods. The hepatitis patients were grouped. Then,the experimental results were compared. Results Serum T3,FT4 in patients with mild liver disease and Serum T3,T4 in patients with moderate liver disease were higher than those in healthy controls;the levels of T3,FT3 in patients with severe liver disease were lower than those in patients with mild and moderate liver disease（P 0.05）;T3,T4,FT3 and TSH in patients who occurred chronic hepatitis with jaundice were significantly lower than those in patients who occurred chronic hepatitis without jaundice（P 0.01） ,T3,T4 in patients with chronic hepatitis was higher than those in patients with cirrhosis（P 0.05）;T3,T4,FT3,TSH in improved hepatitis patients group were higher than non-improved hepatitis patients group（P 0.05） . Conclusion Liver damage and thyroid hormone levels in patients with viral hepatitis are significantly correlated,monitoring the levels of thyroid hormone has important value to the clinical diagnosis,treatment and efficacy in thyroid dysfunction which is caused by the impaired liver function.