解放军医学院学报
解放軍醫學院學報
해방군의학원학보
Academic Journal of Chinese Pla Medical School
2015年
11期
1089-1092
,共4页
王晗%谢娜%徐军%赵静%陈霖%卞成蓉%刘爱霞%戴亮%张岚%毛远丽%李伯安
王晗%謝娜%徐軍%趙靜%陳霖%卞成蓉%劉愛霞%戴亮%張嵐%毛遠麗%李伯安
왕함%사나%서군%조정%진림%변성용%류애하%대량%장람%모원려%리백안
甲状腺功能异常%慢性丙型肝炎%干扰素-α%甲状腺过氧化物酶抗体
甲狀腺功能異常%慢性丙型肝炎%榦擾素-α%甲狀腺過氧化物酶抗體
갑상선공능이상%만성병형간염%간우소-α%갑상선과양화물매항체
thyroid dysfunction%chronic hepatitis C%interferon-alpha%pretreatment thyroid peroxidase antibody
目的：探讨丙型肝炎患者行以干扰素-α(interferon-alpha，IFN-α)为基础的抗病毒治疗后诱发甲状腺功能异常(thyroid dysfunction，TD)的临床特点及影响因素。方法以2013年10月-2014年4月我院收治的432例经以干扰素-α为基础抗病毒治疗的慢性丙型肝炎(chronic hepatitis C，CHC)患者为研究对象，男性259例(60.0%)，女性173例(40.0%)，平均年龄(43.5±32.7)岁。分别采用化学发光法、酶法、荧光定量PCR技术等检测患者抗病毒治疗前和治疗后3个月、6个月、9个月、12个月甲状腺功能、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)、肝功能、HCV RNA和HCV RNA分型等指标。结果经以干扰素-α为基础抗病毒治疗后，67例(15.5%)发展为TD，其中甲状腺功能减退症占58.2%。男女发病比例1∶3.8。32例(47.8%)为治疗后3个月内发生，58例(86.6%)在6个月内出现。停止抗病毒治疗后，63例(94.0%)12个月内自发或经药物治疗后甲状腺功能恢复正常，仅4例(6.0%)发展为持续性TD。多元逐步回归分析表明，性别和治疗前甲状腺自身抗体TPOAb、TGAb是TD发生的独立风险因素。结论 CHC患者行以干扰素-α为基础抗病毒治疗后，15.5%患者发展为TD，以女性为主。女性和治疗前TPOAb及TGAb阳性是发展为TD的危险因素。
目的：探討丙型肝炎患者行以榦擾素-α(interferon-alpha，IFN-α)為基礎的抗病毒治療後誘髮甲狀腺功能異常(thyroid dysfunction，TD)的臨床特點及影響因素。方法以2013年10月-2014年4月我院收治的432例經以榦擾素-α為基礎抗病毒治療的慢性丙型肝炎(chronic hepatitis C，CHC)患者為研究對象，男性259例(60.0%)，女性173例(40.0%)，平均年齡(43.5±32.7)歲。分彆採用化學髮光法、酶法、熒光定量PCR技術等檢測患者抗病毒治療前和治療後3箇月、6箇月、9箇月、12箇月甲狀腺功能、抗甲狀腺過氧化物酶抗體(TPOAb)、抗甲狀腺毬蛋白抗體(TGAb)、肝功能、HCV RNA和HCV RNA分型等指標。結果經以榦擾素-α為基礎抗病毒治療後，67例(15.5%)髮展為TD，其中甲狀腺功能減退癥佔58.2%。男女髮病比例1∶3.8。32例(47.8%)為治療後3箇月內髮生，58例(86.6%)在6箇月內齣現。停止抗病毒治療後，63例(94.0%)12箇月內自髮或經藥物治療後甲狀腺功能恢複正常，僅4例(6.0%)髮展為持續性TD。多元逐步迴歸分析錶明，性彆和治療前甲狀腺自身抗體TPOAb、TGAb是TD髮生的獨立風險因素。結論 CHC患者行以榦擾素-α為基礎抗病毒治療後，15.5%患者髮展為TD，以女性為主。女性和治療前TPOAb及TGAb暘性是髮展為TD的危險因素。
목적：탐토병형간염환자행이간우소-α(interferon-alpha，IFN-α)위기출적항병독치료후유발갑상선공능이상(thyroid dysfunction，TD)적림상특점급영향인소。방법이2013년10월-2014년4월아원수치적432례경이간우소-α위기출항병독치료적만성병형간염(chronic hepatitis C，CHC)환자위연구대상，남성259례(60.0%)，녀성173례(40.0%)，평균년령(43.5±32.7)세。분별채용화학발광법、매법、형광정량PCR기술등검측환자항병독치료전화치료후3개월、6개월、9개월、12개월갑상선공능、항갑상선과양화물매항체(TPOAb)、항갑상선구단백항체(TGAb)、간공능、HCV RNA화HCV RNA분형등지표。결과경이간우소-α위기출항병독치료후，67례(15.5%)발전위TD，기중갑상선공능감퇴증점58.2%。남녀발병비례1∶3.8。32례(47.8%)위치료후3개월내발생，58례(86.6%)재6개월내출현。정지항병독치료후，63례(94.0%)12개월내자발혹경약물치료후갑상선공능회복정상，부4례(6.0%)발전위지속성TD。다원축보회귀분석표명，성별화치료전갑상선자신항체TPOAb、TGAb시TD발생적독립풍험인소。결론 CHC환자행이간우소-α위기출항병독치료후，15.5%환자발전위TD，이녀성위주。녀성화치료전TPOAb급TGAb양성시발전위TD적위험인소。
Objective To investigate clinical characteristics and predictive factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) receiving IFN-α based treatment.Methods Four hundred and thirty-two consecutive CHC patients with normal baseline thyroid functions who received IFN-α based therapy in our hospital from October 2013 to April 2014 were enrolled in this study. There were 259 males (60.0%) and 173 females (40.0%) with an average age of (43.5±32.7) years. Thyroid and liver function, TPOAb, TGAb, HCV RNA and HCV RNA types before and 3, 6, 9, 12 months after treatment were detected by Chemiluminescence, enzymatic andfluorescent quantitative PCR technology, respectively.Results At the end of IFN-α based therapy, 67 patients (15.5%) in this study had developed with TD while the hypothyroidism patients took the most. The percentage of hypothyroid ism accounted for 58.2%. The incidence of this disease in female was higher than male with male to female ratio of 3.8∶1.The cumulative incidence at three, six months after ini tiation of IFN-αbased HCV treatment was 47.8% (32 patients) and 86.6% (58 patients), respectively. The thyroid function of 63 patients (74.6%) spontaneously returned to nor mal in the follow-up period of 12 months and only 4 patients (6%) had persistent overt TD symptoms. Multivariate stepwise analysis suggested that gender and pretreatment TPOAb, TGAb were the independent factors related to the incidence of TD.Conclusion The incidence of TD in patients with CHC during IFN-αbased therapy is 15.5%, taking female as the main. Female gender, pretreatment TPOAb and TGAb positiv ity are risk factors for the development of TD during IFN-αbased therapy.
