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[目的]研究肝硬化患者的血清甲状腺激素水平变化及其临床意义。[方法]用电化学发光法检测了104例肝硬化患者促甲状腺素(TSH)、血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,并与健康体检者对照。按照肝功能分级(Child-Pugh积分法)比较。[结果]肝硬化患者血清FT3、FT4较正常对照组显著降低(t=11.586、5.309,P<0.001);肝功能B级患者的FT3较A级下降(P=0.003),肝功能C级患者的FT3较A级明显下降(P<0.001);肝硬化患者Child-Pugh肝功能分级与FT3负相关(r=-0.370,P<0.001)。[结论]随着肝硬化肝功能损害程度的加重,血清FT3、FT4呈下降趋势,血清FT3水平与肝功能损害程度密切相关。血清FT3水平变化对判断肝硬化严重程度,指导临床治疗及判断预后具有一定的临床价值。
[Objective] To study the changes of serum thyroid hormone in patients with cirrhosis and its clinical significance. [Method] The levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) in 104 cirrhotic patients were detected by electrochemiluminescence method and compared with healthy subjects. According to liver function grading (Child-Pugh integral method) comparison. [Results] The serum levels of FT3 and FT4 in cirrhotic patients were significantly lower than those in normal controls (t = 11.586,5.309, P <0.001); FT3 in patients with grade B liver cirrhosis was lower than those in patients with grade A (P = 0.003) (P <0.001). There was a negative correlation between Child-Pugh liver function classification and FT3 in patients with cirrhosis (r = -0.370, P <0.001). [Conclusion] With the aggravation of hepatic cirrhosis, the serum levels of FT3 and FT4 are decreasing. The level of serum FT3 is closely related to the degree of liver dysfunction. Changes in serum FT3 levels to determine the severity of cirrhosis, clinical treatment and prognosis of prognosis has some clinical value.