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目的了解慢性丙型肝炎患者应用聚乙二醇干扰素治疗期间甲状腺疾病发生情况及其与肝功能、病毒复制、肝硬化发生及合并症的关系。方法收集117例治疗前排除基础甲状腺功能异常的慢性丙型肝炎患者的临床资料和血清标本,抗病毒治疗完成规定标准疗程,分析甲状腺疾病发生情况及其对病情的影响。结果经治疗患者中23例出现甲状腺疾病,其中3例甲状腺功能亢进(甲亢),7例甲状腺功能减低(甲减),11例亚临床甲状腺功能减低(亚甲减),2例低T3综合征。甲状腺功能异常组与甲状腺功能正常组在谷丙转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总蛋白(TP)、HCV-RNA、定量、肝硬化发生率及合并症方面比较,差异无统计学意义(P>0.05);甲状腺功能异常组白蛋白(ALB)水平高于甲状腺功能正常组(P<0.05)。结论应用聚乙二醇干扰素联合利巴韦林抗病毒治疗可增加慢性丙型肝炎患者甲状腺功能异常的发生率,甲状腺功能异常对慢性丙型肝炎患者的肝功能、病毒复制及抗病毒治疗应答率无明显影响。
Objective To investigate the incidence of thyroid disease and its relationship with liver function, viral replication, cirrhosis and comorbidities in patients with chronic hepatitis C treated by peginterferon. Methods The clinical data and serum samples of 117 patients with chronic hepatitis C who had undergone thyroid dysfunction before treatment were collected. Antiviral therapy was performed to complete the prescribed standard course of treatment and the incidence of thyroid disease and its effect on the disease were analyzed. Results Twenty-three patients had thyroid disease, including 3 with hyperthyroidism, 7 with hypothyroidism (hypothyroidism), 11 with subclinical hypothyroidism (hypothyroidism), 2 with low T3 syndrome . Thyroid dysfunction group and normal thyroid function group in the alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), HCV-RNA, quantitative, the incidence of cirrhosis and comorbidities, the difference was not (P> 0.05). The level of albumin (ALB) in patients with abnormal thyroid function was higher than that in patients with normal thyroid function (P <0.05). Conclusion The combination of pegylated interferon and ribavirin can increase the incidence of thyroid dysfunction in patients with chronic hepatitis C and the abnormal thyroid function response to liver function, viral replication and antiviral therapy in patients with chronic hepatitis C Rate no significant effect.