CAJ | 학술논문

目的：研究慢性乙型肝炎患者使用干扰素（INF）治疗后发生甲状腺功能异常的情况及其相关因素的分析。方法回顾性分析213例应用IN F治疗慢性乙型肝炎的患者，治疗48周，停药后随访48周，观察治疗前后甲状腺功能的异常情况及其影响因素，并经Logistic回归分析发生甲状腺功能异常的危险因素。结果213例接受INF治疗的患者中，有38例发生甲状腺功能异常，包括甲状腺功能减退有9例，其中6例桥本甲状腺炎、3例非自身免疫性甲状腺功能减退，甲状腺功能亢进有6例，其中3例Graves病，3例破坏性甲状腺炎；亚临床甲状腺功能亢进5例；亚临床甲状腺功能减退18例。治疗结束后随访48周，所有患者的甲状腺功能均恢复正常。多元Logistic回归分析显示，女性（OR＝3．696）、同期丙型肝炎病毒（HCV）感染（OR＝3．675）、体内预存抗甲状腺自身抗体（OR＝2．008）是慢性乙型肝炎患者使用INF治疗后诱发甲状腺疾病的独立危险因素。结论对慢性乙型肝炎病毒患者使用IN F治疗时，尤其是体内预存大量抗甲状腺过氧化物酶抗体，合并丙型肝炎病毒感染的女性，要监测甲状腺功能相关指标，定期复查，预防甲状腺疾病的发生。
목적：연구만성을형간염환자사용간우소（INF）치료후발생갑상선공능이상적정황급기상관인소적분석。방법회고성분석213례응용IN F치료만성을형간염적환자，치료48주，정약후수방48주，관찰치료전후갑상선공능적이상정황급기영향인소，병경Logistic회귀분석발생갑상선공능이상적위험인소。결과213례접수INF치료적환자중，유38례발생갑상선공능이상，포괄갑상선공능감퇴유9례，기중6례교본갑상선염、3례비자신면역성갑상선공능감퇴，갑상선공능항진유6례，기중3례Graves병，3례파배성갑상선염；아림상갑상선공능항진5례；아림상갑상선공능감퇴18례。치료결속후수방48주，소유환자적갑상선공능균회복정상。다원Logistic회귀분석현시，녀성（OR＝3．696）、동기병형간염병독（HCV）감염（OR＝3．675）、체내예존항갑상선자신항체（OR＝2．008）시만성을형간염환자사용INF치료후유발갑상선질병적독립위험인소。결론대만성을형간염병독환자사용IN F치료시，우기시체내예존대량항갑상선과양화물매항체，합병병형간염병독감염적녀성，요감측갑상선공능상관지표，정기복사，예방갑상선질병적발생。
Objective To investigate and analyze the related factors about the occurrence of thyroid diseases induced by interfer‐on in treating the chronic hepatitis B .Methods A retrospective analysis and following up of 213 interferon‐treated patients with chronic hepatitis B were performed .They were treated for 48 weeks and Logistic regression analysis was performed to evaluate the risk factors of thyroid dysfuncion .Patients were followed up for 48 weeks after drug withdrawal .Results In 213 patients received interferon therapy ,there were 38 cases suffered thyroid dysfunction ,nine of which were hypothyroidism including six cases of Hashimoto′s disease and 3 cases of non‐autoimmune thyroid dysfunction ,six of which were hyperthyroidism including 3 cases of Grave disease and 3 cases of destructive thyroiditis ,five of which were subclinical hyperthyroidism and 18 of which were subclinical hypothyroidism .Until 48 weeks of following‐up after treatment ,all patients with thyroid function was normal .Logistic regression a‐nalysis showed that the risk factors of female(OR=3 .696) ,hepatitis C virus infection over the same period (OR=3 .675) and pre‐stored anti‐thyroid peroxidase antibody(OR=2 .008) were correlated independently with the suffering of interferon induced thyroid diseases in the chronic hepatitis B patients .Conclusion For patients with chronic hepatitis B virus using interferon therapy ,espe‐cially the woman who pre‐stored anti‐thyroid peroxidase antibody in a large number and infected with hepatitis C virus ,the clinical therapy should monitor the related index of thyroid function regularly to prevent the happening of thyroid diseases .