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目的探讨慢性HBV感染合并甲状腺功能亢进症(甲亢)的临床特点及治疗方法。方法对16例慢性HBV感染合并甲亢患者的临床资料进行回顾性分析。结果 16例慢性HBV感染合并甲亢患者,年龄22~62岁,平均年龄33.5岁,男性5例,女性11例。所有患者均有不同程度的甲亢和肝炎症状,以疲乏、食欲不振为主要临床表现14例,占87.50%;体重明显下降者8例,占50.0%,体重下降范围为3~12kg/w;恶心、呕吐6例,占37.50%;食欲亢进仅1例,占6.25%。甲状腺肿大12例,占75.00%,其中Ⅰ~Ⅱ度肿大7例,占43.75%;ALT升高12例,轻度7例、中度4例、重度1例;胆红素升高11例,多数为轻度升高,最高者为40.97μmol/L。心电图正常9例,占56.25%,窦性心动过速4例,占25.00%。单纯治疗肝炎对甲亢无改善,联合甲亢治疗药物肝功、甲功均得到好转。结论 HBV感染者,体重明显下降,食欲不振程度与肝功能损害程度不平行时,应警惕甲亢存在可能,特别是甲状腺肿大、心率增快者。除综合治疗肝炎外,应积极治疗甲亢,抗甲亢药物和放射性碘-131治疗均可选用。
Objective To investigate the clinical features and treatment of chronic HBV infection complicated with hyperthyroidism (Hyperthyroidism). Methods The clinical data of 16 patients with chronic HBV infection complicated with hyperthyroidism were retrospectively analyzed. Results 16 cases of chronic HBV infection with hyperthyroidism, aged 22 to 62 years, mean age 33.5 years, 5 males and 11 females. All patients had different degrees of hyperthyroidism and hepatitis symptoms, fatigue, loss of appetite as the main clinical manifestations in 14 cases, accounting for 87.50%; significant weight loss in 8 cases, accounting for 50.0%, weight loss range of 3 ~ 12kg / w; nausea , Vomiting in 6 cases, accounting for 37.50%; appetite hyperthyroidism in only 1 case, accounting for 6.25%. Goiter in 12 cases, accounting for 75.00%, of which Ⅰ ~ Ⅱ degree enlargement in 7 cases, accounting for 43.75%; ALT increased in 12 cases, mild in 4 cases, moderate in 1 case, elevated bilirubin 11 For example, the majority of mild increase, the highest was 40.97μmol / L. 9 cases of normal ECG, accounting for 56.25%, 4 cases of sinus tachycardia, accounting for 25.00%. Simple treatment of hepatitis without improvement of hyperthyroidism, combined with hyperthyroidism treatment of liver function, Jia Gong have been improved. Conclusion HBV infection, weight decreased significantly, the degree of loss of appetite and liver damage is not parallel, should be alert to the possibility of hyperthyroidism, especially goiter, heart rate faster. In addition to the comprehensive treatment of hepatitis, should actively treat hyperthyroidism, anti-hyperthyroidism drugs and radioactive iodine -131 treatment can be used.