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目的通过检测临床确诊为慢性乙型肝炎患者血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、甲状腺激素T3、T4及促甲状腺素(TSH)含量,进一步探讨慢性乙型肝炎患者肝损情况与甲状腺分泌功能的关系。方法收集2009年1-4月79例确诊为慢性乙型肝炎患者(病例组)血清标本,分别检测其ALT、AST、甲状腺激素T3、T4及TSH含量。以同期健康体检者30例作为对照组。比较两组的差异及各指标间的相关性。结果病例组AST为(87±113)U/L、ALT为(135±241)U/L、AST/ALT为0.97±0.57、TSH为(1.63±1.29)mU/L、T3为(1.61±0.52)ng/mL、T4为(10.7±2.9)μg/dL,对照组分别为(23±5)U/L、(18±5)U/L、1.31±0.26、(2.13±0.90)mU/L、(1.19±0.16)ng/mL和(8.6±0.9)μg/dL,两组各指标比较均有统计学差异(P<0.01)。所有指标均正常的共有6例(7.6%),有73例(92.4%)存在不同程度的指标异常;在68例AST/ALT比值降低的慢性乙型肝炎患者(93.2%)中,伴有单纯T4升高的有11例(16.2%),单纯T3升高的有4例(5.9%),T3、T4同时升高的有11例(16.2%),T3、T4同时升高且TSH降低的有2例(2.9%),1例T4升高且TSH降低(1.5%),1例仅TSH升高(1.5%);在4例AST/ALT比值正常的慢性乙型肝炎患者(5.5%)中,有1例T3、T4同时升高且TSH降低,1例T3和T4同时升高,1例单纯T4升高,1例单纯TSH降低;有1例仅AST/ALT比值升高而其他项正常。结论慢性乙型肝炎患者除AST/ALT比值异常外,还同时伴有不同程度的甲状腺激素指标异常,其原因可能与慢性乙型肝炎应用干扰素治疗时甲状腺功能受损有关。
Objective To explore the relationship between liver damage and serum levels of ALT, AST, thyroid hormones T3, T4 and thyrotropin (TSH) in patients with chronic hepatitis B Thyroid secretion function of the relationship. Methods Serum samples of 79 patients diagnosed as chronic hepatitis B (case group) from January to April in 2009 were collected and the levels of ALT, AST, thyroid hormones T3, T4 and TSH were detected. In the same period, 30 cases of healthy physical examination as a control group. The differences between the two groups and the correlation between the indexes were compared. Results The serum levels of AST in the cases were (87 ± 113) U / L, ALT was (135 ± 241) U / L, AST / ALT was 0.97 ± 0.57, TSH was (1.63 ± 1.29) mU / (10 ± 2.9) μg / dL and (23 ± 5) U / L, (18 ± 5) U / L and 1.31 ± 0.26 and (2.13 ± 0.90) mU / L , (1.19 ± 0.16) ng / mL and (8.6 ± 0.9) μg / dL, respectively. There were significant differences between the two groups (P <0.01). There were 6 cases (7.6%) with normal indexes and 73 cases (92.4%) with abnormal indexes. Among 68 patients with chronic hepatitis B (93.2%) with reduced AST / ALT ratio, T4 increased in 11 cases (16.2%), simple T3 increased in 4 cases (5.9%), T3, T4 elevated in 11 cases (16.2%), T3, T4 increased at the same time and TSH decreased There were 2 cases (2.9%), 1 case of T4 elevation and TSH reduction (1.5%) and 1 case of TSH alone (1.5%). In 4 cases of chronic hepatitis B patients with normal AST / ALT ratio (5.5% , One case of T3 and T4 elevated at the same time and TSH decreased, one case of T3 and T4 elevated at the same time, one case of simple T4 increased, and one case of simple TSH decreased; only one AST / ALT ratio increased while the others normal. Conclusion In addition to the abnormal AST / ALT ratio, patients with chronic hepatitis B have abnormal levels of thyroid hormone, which may be related to the impaired thyroid function in chronic hepatitis B patients treated with interferon.