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肝脏疾病对甲状腺功能的影响

THYROID FUNCTIONS IN PATIENTS WITH HEPATIC DISEASES

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【作者】 杨宗于苟淑芹齐桂英陈晓萌

【Author】 Dept of Nucl Med,People’s Hospital Beijing Medical University Yang Zongyu

【机构】 北京医科大学人民医院核医学科北京医科大学人民医院核医学科

【摘要】 本文观察了23例急性肝炎,25例慢性迁延型肝炎,21例慢性活动型肝炎,26例门脉性肝硬比患者甲状腺功能的变化,发现仅16例肝硬化失代偿期患者血清T1和T3浓度明显下降,FT1I亦下降,而γT3、γT3/T3比值明显上升,TSH浓度轻度上升。血清T3浓度与血清白蛋白浓度呈正相关,γT3浓度与血清白蛋白浓度呈负相关,其他各型肝病无明显改变。肝硬化患者血清T1、T3浓度愈低,γT3浓度愈高,则其预后亦愈差。本文并对肝硬化失代偿期患者甲状腺功能变化机理及其临床意义进行了初步探讨。

【Abstract】 Thyroid functions were studied in 23 cases of acute hepatitis,25 cases of chronic persistent hepatitis,21 cases of chronic active hepatitis, and 26 cases of portal cirrhosis. It was found that in 16 of the 26 decompensated cirrhatic patients the concentration of serum T1.T3.and FT11 was significantly decreased. whereas the concentration of rT3and rT3/T3was significantly increased. The concentration of serum TSH was also increased .though not statistically significant. In cirrhotic patients, the concentration of serum T3was positively, and that of rT3was negatively correlated with the concentration serum albumin. It was also found that in cirrhotic patients the lower the level of serum T1and T3.the higher the level of rT3and the poorer the prognosis were. The mechanism of abnormal thyroid functions in decompensated cirrhotic patients and its clin ical implications were briefly discussed.

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