CAJ | 학술논문

目的：探讨α干扰素治疗的慢性乙型肝炎儿童诱发甲状腺功能紊乱的临床特点。方法2010年1月至2011年12月在解放军第302医院青少年肝病科住院，干扰素α为基础抗病毒治疗并随访的慢性乙型肝炎儿童406例，每24周检查甲状腺功能五项，对随访的结果进行统计分析。结果（1）本组患儿25.86%出现甲状腺功能紊乱，以亚临床甲状腺功能减退为主（17.98%），6.16%出现甲状腺功能减退症，1.72%为甲状腺功能亢进症；幼儿组（1～3岁）患儿未见甲状腺功能亢进症，4～7岁（7.55%）及8～16岁（9.26%）组甲状腺功能减退症的发生率明显高于幼儿组（1.44%）。甲状腺功能减退症患儿中女性（11.11%）的发生率明显高于男性（4.15%）。（2）68%的甲状腺功能减退症患儿、42.86%的甲状腺功能亢进症患儿有临床表现；治疗前过氧化酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）升高的患儿均进展为甲状腺功能疾病。（3）Logistic 结果显示，甲状腺功能亢进症和甲状腺功能减退症的发生与女性及治疗前治疗中出现 TPOAb、TgAb 升高相关。结论α干扰素治疗的慢性乙型肝炎儿童诱发甲状腺功能紊乱以亚临床甲状腺功能减退为主，甲状腺功能亢进症和甲状腺功能减退症的发生与女性及治疗前治疗中出现TPOAb、TgAb升高相关。
목적：탐토α간우소치료적만성을형간염인동유발갑상선공능문란적림상특점。방법2010년1월지2011년12월재해방군제302의원청소년간병과주원，간우소α위기출항병독치료병수방적만성을형간염인동406례，매24주검사갑상선공능오항，대수방적결과진행통계분석。결과（1）본조환인25.86%출현갑상선공능문란，이아림상갑상선공능감퇴위주（17.98%），6.16%출현갑상선공능감퇴증，1.72%위갑상선공능항진증；유인조（1～3세）환인미견갑상선공능항진증，4～7세（7.55%）급8～16세（9.26%）조갑상선공능감퇴증적발생솔명현고우유인조（1.44%）。갑상선공능감퇴증환인중녀성（11.11%）적발생솔명현고우남성（4.15%）。（2）68%적갑상선공능감퇴증환인、42.86%적갑상선공능항진증환인유림상표현；치료전과양화매항체（TPOAb）、갑상선구단백항체（TgAb）승고적환인균진전위갑상선공능질병。（3）Logistic 결과현시，갑상선공능항진증화갑상선공능감퇴증적발생여녀성급치료전치료중출현 TPOAb、TgAb 승고상관。결론α간우소치료적만성을형간염인동유발갑상선공능문란이아림상갑상선공능감퇴위주，갑상선공능항진증화갑상선공능감퇴증적발생여녀성급치료전치료중출현TPOAb、TgAb승고상관。
Objective To investigate the clinical characteristics of IFNα treatment-induced thyroid dysfunction of children patients with chronic hepatitis B. Methods 406 chronic hepatitis B children enrolled from Jan. 2010 to Dec. 2011 in the Pediatric Liver Disease Therapy and Research Center of 302 Military Hospital of China were collected. All patients having received interferonα-based antiviral therapy underwent a thyroid function examination every 24 weeks, grounded on which a follow-up evaluation was conducted in this paper. Results (1)The incidence of thyroid dysfunction was 25.86%, of which the occurrence of subclinical hypothyroidism accounts for 17.98%, hypothyroidism occurring by 6.16%, and hyperthyroidism by 1.72%. In terms of age groups it was revealed that hyperthyroidism wasn't detected in the infant patients group(under 3 years old). In addition, the incidence of hypothyroidism among patients in the 4-7 years bracket (by 7.55%) and 8-16 years old group (by 9.26%) was significantly stronger than that found in infant group (by 1.44%). Moreover, the incidence of hypothyroidism among female patients (by 11.11%) was significantly higher than that of males (by 4.15%). (2) Clinical symptoms were detected in 68% of hypothyroidism patients and 42.86% of hyperthyroidism patients sampled-all showed pre-treatment elevation of TPOAb, TgAb levels which has developed into thyroid disease. (3) Logistic regression analysis results showed that the thyroid disease more likely attacked females and those exhibiting elevation of TPOAb, TgAb levels prior to or during the therapeutic process. Conclusion Most cases of the thyroid dysfunction induced by IFNα therapy for chronic hepatitis B children patients were characterized by subclinical hypothyroidism; The thyroid disease more likely affects female patients and those showing elevation of TPOAb, TgAb levels prior to or during the therapeutic process.