CAJ | 학술논문

目的探讨Graves病(GD)患者甲亢性肝损害的发生率及其相关因素.方法 GD患者280例,分为未治组(131例)和经治组(149例),检测肝功能指标、血清甲状腺激素水平、甲状腺自身抗体.对其肝功能损害的发生率、临床特点及相关因素进行分析.结果在未治组甲亢性肝功能损害的发生率为70.99%,经治组为61.07%;甲亢性肝功能损害最常见的异常指标是碱性磷酸酶(ALP)增高,未治组、经治组分别为57.3%、51.0%;血清谷丙转氨酶(ALT)异常在两组的发生率分别为28.2%、21.5%;血清谷草转氨酶(AST)异常在两组的发生率分别为18.3%、15.4%;总胆红素异常在两组的发生率分别为21.4%、20.1%;谷酰胺转肽酶(GGT)异常的发生率未治组和经治组分别为10.7%、4.7%;甲亢性肝功能损害的发生与病程、甲状腺疾病家族史、性别、TGAb水平、TMAb水平无关,与年龄、甲状腺激素水平有关.结论 GD患者甲亢性肝损害较常见,肝功能损害最常见的异常指标是ALP、ALT,甲亢性肝功能损害与甲状腺激素水平、年龄有关.
목적 탐토Graves병(GD)환자갑항성간손해적발생솔급기상관인소.방법 GD환자280례,분위미치조(131례)화경치조(149례),검측간공능지표、혈청갑상선격소수평、갑상선자신항체.대기간공능손해적발생솔、림상특점급상관인소진행분석.결과 재미치조갑항성간공능손해적발생솔위70.99%,경치조위61.07%;갑항성간공능손해최상견적이상지표시감성린산매(ALP)증고,미치조、경치조분별위57.3%、51.0%;혈청곡병전안매(ALT)이상재량조적발생솔분별위28.2%、21.5%;혈청곡초전안매(AST)이상재량조적발생솔분별위18.3%、15.4%;총담홍소이상재량조적발생솔분별위21.4%、20.1%;곡선알전태매(GGT)이상적발생솔미치조화경치조분별위10.7%、4.7%;갑항성간공능손해적발생여병정、갑상선질병가족사、성별、TGAb수평、TMAb수평무관,여년령、갑상선격소수평유관.결론 GD환자갑항성간손해교상견,간공능손해최상견적이상지표시ALP、ALT,갑항성간공능손해여갑상선격소수평、년령유관.
Objective To investigate the incidence and the possible risk factors of hepatic dysfunction in patients with Graves' disease (GD). Methods Totally 280 outpatients with hyperthyroidism (caused by GD) were divided in two groups: untreated group (131 patients) and treated group (149 patients). The hepatic function, serum thyroid hormone, TGAb and TMAb were detected for analysis of the incidence, clinical characteristics and correlative factors of the hepatic dysfunction. Results Patients who had at least one abnormal result of liver function test accounted for 70.99% in untreated group and 61.07% in treated group. The most common abnormal hepatic function parameter in patients with thyrotoxic hepatic lesion was increased alkaline phosphate enzyme (ALP), which was 57.3% in untreated group and 51.0% in treated group. Abnormalities of alanine transaminase (ALT), aspartate transaminase(AST), gamma-glutamyl tyanspeptidase (GGT) and total bilirubin (TBIL) were 28.2% (37/131), 18.3% (24/131), 10.7% (14/131) and 21.4% (28/131) in untreated group and 21.5%(32/149), 15.4%(23/148), 4.7% (7/149) and 20.1% (30/149) in treated group, respectively. The possibility of thyrotoxic hepatic dysfunction was correlated with the patients' age and FT3 and FT4 levels, but not with the genesis and course of disease, sex, family history of hyperthyroidism, or levels of TGAb and TMAb. Conclusion Abnormal results of liver function test are commom in patients with hyperthyroidism. Increased alkaline phosphate enzyme and alanine transaminase are the most common abnormal hepatic function parameters; the possibility of thyrotoxic hepatic dysfunction is correlated with patients' age and the level of thyroid hormones.