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目的:比较非酒精性肝硬化伴或不伴有肝性脑病患者的甲状腺激素水平变化并评价其临床意义。方法:非酒精性肝硬化肝性脑病患者18例,非酒精性肝硬化无肝性脑病患者30例,正常健康对照者18例,所有患者行甲状腺功能检查,包括四碘甲状腺原氨酸(T_4)、三碘甲状腺原氨酸(T_3),游离四碘甲状腺原氨酸(FT_4)、游离三碘甲状腺原氨酸(FT_3)及促甲状腺素(TSH),以及肝功能检查。分析甲状腺激素水平与肝病严重程度及与肝性脑病的关系。结果:非酒精性肝硬化肝性脑病患者FT_3较肝硬化无肝性脑病患者明显降低。肝硬化无肝性脑病患者Child C较Child A和Child B患者FT_3降低,肝性脑病患者与肝硬化Child A,Child B和Child C患者比较凝血酶原时间明显延长。结论:非酒精性肝硬化患者血清T_3浓度越低,肝功能损害程度越重,在伴有肝性脑病患者T3水平最低,血清T3浓度是判断肝功能的敏感指标。
Objective: To compare the changes of thyroid hormone levels in patients with non-alcoholic cirrhosis and hepatic encephalopathy and to evaluate their clinical significance. Methods: Eighteen patients with hepatic encephalopathy of non-alcoholic cirrhosis, 30 patients with non-hepatic cirrhosis of non-alcoholic cirrhosis and 18 healthy controls were enrolled in this study. All patients underwent thyroid function tests, including tetraiodothyronine (T_4 ), Triiodothyronine (T_3), free tetraiodothyronine (FT_4), free triiodothyronine (FT_3) and thyrotropin (TSH), and liver function tests. To analyze the relationship between thyroid hormone level and the severity of liver disease and hepatic encephalopathy. Results: FT_3 in non-alcoholic cirrhotic patients with hepatic encephalopathy was significantly lower than that in patients with cirrhosis without hepatic encephalopathy. Child C in patients with cirrhosis without hepatic encephalopathy was lower than Child A and Child B patients FT_3, prothrombin time was significantly longer in patients with hepatic encephalopathy and cirrhosis Child A, Child B and Child C patients. Conclusion: The lower serum T_3 concentration in non-alcoholic cirrhosis patients is, the more severe the liver damage is. The T3 level is the lowest in patients with hepatic encephalopathy, and the serum T3 concentration is a sensitive index to judge the liver function.