CAJ | 학술논문

目的：分析甲状腺功能亢进症(简称甲亢)并发肝功能损害临床表现及诊断治疗方法。方法回顾性分析38例甲亢并发肝功能损害患者临床资料，并按肝功能损害程度分为肝功能轻度损害组26例和重度损害组12例，分析比较两组甲状腺功能异常程度及与肝功能损害的相关性。结果38例中肝功能轻度损害26例(68.4％)，显著或重度损害12例(31.6％)；肝功能损害症状：不同程度腹胀、乏力、恶心、尿黄、黄疸等26例，肝肿大2例，无明显肝功能损害症状10例。肝功能重度损害组游离三碘甲状腺原氨酸和游离甲状腺素明显高于轻度损害组(t =3.16、3.27，均P＜0.05)，而促甲状腺素明显低于轻度损害组(t=3.09，P＜0.05)。38例患者均治愈，甲亢症状均得到控制。抗甲状腺药物治疗或131 I治疗的病例未见肝功能损害症状加重。结论甲亢可致肝功能损害，其损害程度与甲状腺功能异常程度成正比，其表现轻重不一，甚至无症状甲亢并发轻度肝功能损害时，采用抗甲状腺药物治疗下加重肝功能损害程度，重度肝损害患者宜采用131I治疗。
목적：분석갑상선공능항진증(간칭갑항)병발간공능손해림상표현급진단치료방법。방법회고성분석38례갑항병발간공능손해환자림상자료，병안간공능손해정도분위간공능경도손해조26례화중도손해조12례，분석비교량조갑상선공능이상정도급여간공능손해적상관성。결과38례중간공능경도손해26례(68.4％)，현저혹중도손해12례(31.6％)；간공능손해증상：불동정도복창、핍력、악심、뇨황、황달등26례，간종대2례，무명현간공능손해증상10례。간공능중도손해조유리삼전갑상선원안산화유리갑상선소명현고우경도손해조(t =3.16、3.27，균P＜0.05)，이촉갑상선소명현저우경도손해조(t=3.09，P＜0.05)。38례환자균치유，갑항증상균득도공제。항갑상선약물치료혹131 I치료적병례미견간공능손해증상가중。결론갑항가치간공능손해，기손해정도여갑상선공능이상정도성정비，기표현경중불일，심지무증상갑항병발경도간공능손해시，채용항갑상선약물치료하가중간공능손해정도，중도간손해환자의채용131I치료。
Objective To investigate the clinical manifestation and therapy method of hyperthyroidism accompanied by liver damage. Methods To analyze the clinical data of 38 cases those with hyperthyroidism accompanied by liver damage and divide them by damage degree into two groups,one of which contains mild impairment of 26 cases and the other one contains severe impairment of 12 cases. Then make a analysis about the comparison of the two groups on the level of thyroid disorders and the correlation with liver damage. Results Of all the 38 cases 26 (68. 4％ ) cases have slight liver damage and 12(31.6％ ) cases have severe liver damage. The symptom:26 cases have abdominal distension in different degree, weakness, sickness, port colored urine, aurigo and so on. 2 cases have hepatomegaly. 10 cases have no obvious symptoms of liver damage. The FT3 and FT4 in the severely liver-impaired group is obviously higher than the slightly liver-damaged group( (t =3.16,3.27, allP ＜ 0. 05 ) ,while the TSH is obviously lower( t =3.09 ,P ＜ 0.05 ). 38 cases are all healed and the symptom of hyperthyroidism has got under control. The cases of ATD therapy or 131 I therapy are not any aggravated in liver damage. Conclusion Hyperthyroidism may lead to liver damage whose level is directly proportional to the level of thyroid dysfunction. And the result can be different, even no any symptom.