慢性乙型肝炎合并甲状腺功能亢进症48例分析

摘要

Objective To investigate the clinical features and therapeutic effects of chronic hepatitis B complicated with hyperthyroidism.Methods 48 patients with chronic hepatitis B complicated with hyperthyroidism treated at our hospital from August,2011 to December,2014 were selected.All patients took antiHBV treatment and liver-protective treatment.According to whether choosing anti-hyperthyroidism treatment,they were divided into an anti-hyperthyroidism group (n=31) and a control group (n=1 7).The clinical features of chronic hepatitis B complicated with hyperthyroidism was analyzed.The change of liver function and thyroid function were observed in both groups after the treatment.Results The hospital stay was shorter in the antihyperthyroidism group than in the control group (P＜0.05).68.75％ patients with chronic hepatitis B complicated with hyperthyroidismwas were female.There were no statistical differences in gender,age,and residence place between these two groups (P＞0.05).One month after the treatment,the levels of ALT,AST,TBil,and DBil decased in both groups (P＜0.05) but were higher in the anti-hyperthyroidism group than in the control group (P＜0.05).The liver function was improved less in the anti-hyperthyroidism group than in the control group.The levels of FT3 and FT4 decreased in the anti-hyperthyroidism group (P＜0.05) and were lower in the antihyperthyroidism group than in control group (P＜0.05).The level of TSH increased in the anti-hyperthyroidism group (P＜0.05) and was higher in the anti-hyperthyroidism group than in control group (P＜0.05).Conclusions Patients with chronic hepatitis B complicated with hyperthyroidism should take anti-HBV treatment,liverprotective treatment,and anti-hyperthyroidism treatment so as to improve thyroid function and liver function.%目的 探讨慢性乙型肝炎合并甲状腺功能亢进症的临床特征及治疗效果.方法 选择201 1年8月至2014年12月在本院就诊的48例慢性乙型肝炎合并甲状腺功能亢进症患者,均抗乙肝病毒及护肝治疗,根据是否选择抗甲状腺功能亢进症治疗分为抗甲状腺功能亢进症组31例和不抗甲状腺功能亢进症治疗的对照组17例,分析慢性乙型肝炎合并甲状腺功能亢进症者的临床特征,观察两组治疗后肝功能、甲状腺功能改善情况.结果 抗甲状腺功能亢进症组住院天数小于对照组(P＜0.05);慢性乙型肝炎合并甲状腺功能亢进症者以女性为主(68.75％);而两组性别、年龄、居住地差异无统计学意义(P＞0.05);治疗1月后两组ALT、AST、TBil、DBil均下降(P＜0.05);抗甲状腺功能亢进症组治疗后ALT、AST、TBil、DBil高于对照组(P＜0.05),肝功能改善程度不及对照组;抗甲状腺功能亢进症组治疗后Fr3、Fr4降低(P＜0.05),且低于对照组(P＜0.05),TSH升高(P＜0.05),且高于对照组(P＜0.05).结论 慢性乙型肝炎合并甲状腺功能亢进症患者在抗乙肝病毒及护肝治疗的同时可选择抗甲状腺功能亢进症治疗,可同时改善肝功能及甲状腺功能.