CAJ | 학술논문

目的探讨初诊Graves甲状腺功能亢进症(简称甲亢)合并肝损害的发生率、临床特点及其相关因素.方法回顾性分析初诊Graves甲亢患者204例,根据肝功能是否异常分为肝损害组146例和正常组58例.比较两组患者性别组成、年龄、甲状腺质量、病程、24 h摄131I率、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(TGAb)之间的差异,并对肝功能指标与甲状腺激素进行相关性分析.结果 ①初诊Graves甲亢合并肝损害(至少有一项肝功能指标异常)的发生率为71.6％,以谷丙转氨酶(ALT)异常最常见,发生率为37.7％；肝损害组中仅一项指标异常者61例(41.8％),以碱性磷酸酶(ALP)异常最常见,占50.8％(31/61).②肝损害组较正常组病程长,血FT3、FT4及TRAb水平明显增高,而两组间性别组成、年龄、甲状腺质量、24 h摄131I率、TPOAb、TGAb比较差异无统计学意义.③谷草转氨酶与FT3,ALP与FT3、FT4,总胆红素与FT4,直接胆红素与FT3、FT4均呈正相关.结论初诊Graves甲亢合并肝损害的发生率较高,肝损害最常见的指标包括ALT、ALP水平异常,其发生与甲亢病程、甲状腺激素及TRAb水平密切相关.
목적 탐토초진Graves갑상선공능항진증(간칭갑항)합병간손해적발생솔、림상특점급기상관인소.방법 회고성분석초진Graves갑항환자204례,근거간공능시부이상분위간손해조146례화정상조58례.비교량조환자성별조성、년령、갑상선질량、병정、24 h섭131I솔、유리삼전갑상선원안산(FT3)、유리갑상선소(FT4)、촉갑상선격소수체항체(TRAb)、갑상선과양화물매항체(TPOAb)급갑상선구단백항체(TGAb)지간적차이,병대간공능지표여갑상선격소진행상관성분석.결과 ①초진Graves갑항합병간손해(지소유일항간공능지표이상)적발생솔위71.6％,이곡병전안매(ALT)이상최상견,발생솔위37.7％；간손해조중부일항지표이상자61례(41.8％),이감성린산매(ALP)이상최상견,점50.8％(31/61).②간손해조교정상조병정장,혈FT3、FT4급TRAb수평명현증고,이량조간성별조성、년령、갑상선질량、24 h섭131I솔、TPOAb、TGAb비교차이무통계학의의.③곡초전안매여FT3,ALP여FT3、FT4,총담홍소여FT4,직접담홍소여FT3、FT4균정정상관.결론 초진Graves갑항합병간손해적발생솔교고,간손해최상견적지표포괄ALT、ALP수평이상,기발생여갑항병정、갑상선격소급TRAb수평밀절상관.
Objective To investigate the incidence,clinical features and the possible risk factors of hepatic dysfunction in the newly diagnosed patients with Graves hyperthyroidism.Methods A retrospective analysis about total 204 newly diagnosed patients with Graves hyperthyroidism was studied.All the patients were divided into two groups by liver function:the hepatic dysfunction group (146 cases)and the normal group (58 cases).The gender composition,age,thyroid weight,24 h-131I intake rate,free triiodothyronine (FT3),free thyronine (FT4),thyroid-stimulating hormone receptor antibody (TRAb),thyroid peroxidase antibodies (TPOAb)and thyroglobulin antibody (TGAb)were compared between the two groups.A correlation analysis was progressed between the indicators of liver function and thyroid hormone.Results ①The incidence of hepatic dysfunction (at least one abnormal parameter)in the newly diagnosed patients with Graves hyperthyroidism was 71.6％ and the most familiar abnormal parameter was alanine transaminase (ALT) (37.7 ％).Altogether 61 patients (41.8 ％)had only one abnormal parameter in the hepatic dysfunction group and the most common abnormal parameter was alkaline phosphatase (ALP)(50.8％).②Compared with the normal group,hepatic dysfunction group had longer disease duration,higher serum FT3,FT4 and TRAb levels,but there were no significant differences in gender composition,age,thyroid weight,24 h-1nI intake rate,TPOAb,TGAb between the two groups.③A significantly positive correlation was found between the aspartate aminotransferase and FT3,the ALP and FT3,FT4,the total bilirubin and FT4,the direct bilirubin and FT3,FT4,respectively.Conclusions Hepatic dysfunction in newly diagnosed patients with Graves hyperthyroidism is very common and the most common abnormal parameters include ALT and ALP.The hepatic dysfunction is closely correlated with patients' disease duration,thyroid hormone and TRAb levels.