乙型肝炎患者血清甲状腺激素水平变化及其临床意义

摘要

Objective To investigate the clinical significance and changes of serum level of thyroid hormone in patients with type B hepatitis( HB). Methods Forty-five patients with HB were divided into chronic mild HB group(n =21) .chronic moderate HB group( n = 19) and chronic severe HB group( n = 5). Fifteen healthy persons were selected as control group. The level of thyroid hormone was detected in each group. Results Compared with control group,the levels of total triiodothyronine (TT3) .total thyroxme(TT4)and free triiodothyronine(FT3) were lower( P < 0.05), but the levels of reverse triiodothyronine (rT3) and thyroxine-binding globulin(TBC) were higher in patients with HB(P<0.05). There was significant difference in the indexes among chronic mild HB group,chronic moderate HB group and chronic severe HB group(P <0.05) ;wilh the aggravation of patient's condition,the levels of TT3,TT4 and FT, gradually decreased,while the levels of rT3 and TBG gradually increased. Conclusion Serum thyroid hormone levels can reflect the severity of patients with HB; dynamic monitoring serum thyroid hormone levels have important clinical value.%目的 探讨乙型肝炎患者血清甲状腺激素水平的变化及临床意义.方法 将45例乙型肝炎患者分为慢性轻度组21例,慢性中度组19例和慢性重度组5例；同时选择15例健康人群为对照组,测定各组血清甲状腺激素水平.结果 与对照组比较,乙型肝炎患者血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)水平降低(P＜0.05),而反三碘甲状腺原氨酸(rT3)和甲状腺素结合球蛋白(TBG)水平升高(P＜0.05).慢性轻度组、慢性中度组和慢性重度组3组间各指标两两比较差异均有统计学意义(P＜0.05)；随着患者病情的加重,患者血清TT3、TT4、FT3水平逐渐降低,而rT3、TBG水平逐渐升高.结论 血清甲状腺激素水平可以反映乙型肝炎患者的病情严重程度；动态监测乙型肝炎患者血清甲状腺激素水平具有重要的临床价值.