CAJ | 학술논문

目的：探讨干扰素治疗慢性丙型肝炎患者后发生甲状腺功能异常的情况及相关因素的分析。方法回顾性分析206例慢性丙型肝炎患者，观察89例干扰素治疗前和117例治疗后甲状腺功能的异常情况及其影响因素，Logistic 分析发生甲状腺功能异常的危险因素。结果干扰素治疗前的89例患者中，有23例合并甲状腺功能异常，其中甲状腺功能减退症7例，甲状腺功能亢进症2例，亚临床甲状腺功能减退症14例；干扰素治疗后的117例患者中，有17例发生甲状腺功能异常，其中甲状腺功能减退4例，为桥本甲状腺炎2例和非自身免疫性甲状腺功能减退2例；甲状腺功能亢进1例；亚临床甲状腺功能减退症12例。多元 Logistic 回归分析显示，女性（OR＝5．828）、体内预存抗甲状腺自身抗体（OR＝35．393）是慢性丙型肝炎患者使用干扰素治疗后诱发甲状腺疾病的独立危险因素。结论干扰素治疗慢性丙型肝炎可导致甲状腺功能异常的发生；对体内预存大量抗甲状腺过氧化物酶抗体的女性，要监测甲状腺功能，定期复查。
목적：탐토간우소치료만성병형간염환자후발생갑상선공능이상적정황급상관인소적분석。방법회고성분석206례만성병형간염환자，관찰89례간우소치료전화117례치료후갑상선공능적이상정황급기영향인소，Logistic 분석발생갑상선공능이상적위험인소。결과간우소치료전적89례환자중，유23례합병갑상선공능이상，기중갑상선공능감퇴증7례，갑상선공능항진증2례，아림상갑상선공능감퇴증14례；간우소치료후적117례환자중，유17례발생갑상선공능이상，기중갑상선공능감퇴4례，위교본갑상선염2례화비자신면역성갑상선공능감퇴2례；갑상선공능항진1례；아림상갑상선공능감퇴증12례。다원 Logistic 회귀분석현시，녀성（OR＝5．828）、체내예존항갑상선자신항체（OR＝35．393）시만성병형간염환자사용간우소치료후유발갑상선질병적독립위험인소。결론간우소치료만성병형간염가도치갑상선공능이상적발생；대체내예존대량항갑상선과양화물매항체적녀성，요감측갑상선공능，정기복사。
Objective To investigate and analyze related factors about the occurrence of thyroid diseases induced by interferon in treatment of chronic hepatitis C. Methods A retrospective analysis of 206 patients with chronic hepatitis C (117 interferon-treated patients and 89 non-interferon-treated patients)was performed. Risk factors of thyroid dysfunction were evaluated by logistic regression analysis. Results Among 89 patients without interferon therapy,23 had combined thyroid dysfunction:7 of hypothyroidism,2 of hyperthyroidism and 14 of subclinical hypothyroidism. Among 117 patients receiving interferon therapy,there were 1 7 cases suffering thyroid dysfunction,including 4 of hypothyroidism (2 cases of Hashimoto's disease and 2 cases of non-autoimmune thyroid dysfunction),1 of hyperthyroidism and 12 of subclinical hypothyroidism. Logistic regression analysis showed that the risk factors,which correlated independently with interferon-induced thyroid diseases in patients with chronic hepatitis C,were female (OR= 5 . 828 )and pre-stored anti-thyroid peroxidase antibody (OR= 35.393). Conclusion The rate of thyroid dysfunction in patients with chronic hepatitis C was 25.8% ,and the rate of thyroid dysfunction induced by interferon in patients with chronic hepatitis C was 14.5% . For patients with chronic hepatitis C virus treated with interferon,especially women whose pre-stored anti-thyroid peroxidase antibody is in a large number,related indexes of thyroid function should be monitored regularly to prevent thyroid diseases.