肝病患者血清甲状腺激素异常的临床意义探讨

本文报告用放射免疫法对２３１例不同种类肝病患者及５０名正常人群作血清甲状腺激素含量测定。结果显示不同种类肝病患者血清甲状腺激素Ｔ３含量下降，ｒＴ３含量升高及Ｔ４含量下降，其变化幅度随病情加重呈相应改变，提示Ｔ３和ｒＴ３含量的测定可以作为反映肝功能的一项敏感指标。将Ｔ３、Ｔ４、ｒＴ３及ＴＳＨ与主要肝功能指标──血浆总胆红素、白蛋白、凝血酶原时间分别进行多元线性回归分析，发现Ｔ３与凝血酶原时间呈显著负相关，与白蛋白呈显著正相关；而ｒＴ３与凝血酶原时间呈显著正相关。提示Ｔ３和ｒＴ３含量的测定应作为临床估计病情，评价肝功能判断预后的重要指标。本文还提示在病毒性肝炎患者中有“低Ｔ３综合症”的存在，需与甲减加以鉴别。病毒性肝炎是否存在病毒性甲状腺炎有待进一步研究。据此笔者对肝病时血清甲状腺激素含量异常的机理进行了有益的探索和阐述。

Discusaion on the Relation of Viral Hepatitis and Serum Thyroxin

A systematic observation on the determination of thyroid gland's function in 231 viral hepatitis cases was made from January 1991 to November 1992. The results show that. except for acute anicteric hepatitis. the serum T3 percentage of various viral hepatitis is obviously lower than the normal comparison group(p<0.01 ); the rT3, rT3/T3 , higher than the normal comparison group. And the results of the multiple linear regression analysis indicates that the content of serum T3 should be regarded as the important index in estimating the state of illness, evaluating hepatic function and deciding prognosis.