论文部分内容阅读
目的探讨慢性丙型病毒性肝炎(丙肝)抗病毒治疗中发生甲状腺功能异常的危险因素。方法 131例慢性丙肝患者皮下注射聚乙二醇干扰素α-2a(Peg-IFN-α-2a)180μg,1周1次,联合口服利巴韦林15 mg·kg-1,每日1次,总疗程48周。检测患者治疗前2周内及治疗12,24,36,48周的游离甲状腺激素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)水平和抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)水平。结果治疗后,甲状腺功能异常的发生率为10.69%(14/131),TGAb基线阳性者甲状腺功能异常率为35.7%,高于TGAb阴性者的7.7%,TPOAb的基线阳性者甲状腺功能异常率为57.1%,高于TPOAb阴性者的0.9%(P<0.05)。性别、年龄、干扰素使用疗程等因素与甲状腺功能异常的发生无统计学关联(P>0.05)。结论甲状腺TPOAb、TGAb基线阳性是抗病毒治疗后发生甲状腺功能异常的危险因素,可作为慢性丙肝抗病毒治疗中发生甲状腺功能异常不良反应的监测指标。
Objective To investigate the risk factors of thyroid dysfunction in the treatment of chronic hepatitis C virus (HCV). Methods One hundred and thirty-one chronic hepatitis C patients were injected subcutaneously with Peg-IFN-α-2a (180 μg) once a week for 15 weeks. The patients were given ribavirin 15 mg · kg-1 once daily , The total course of 48 weeks. Free thyroid hormone (FT4), free triiodothyronine (FT3), thyrotropin (TSH) and anti-thyroid peroxidase Antibody (TPOAb), anti-thyroglobulin antibody (TGAb) levels. Results After treatment, the incidence of thyroid dysfunction was 10.69% (14/131). The positive rate of thyroid dysfunction in TGAb-positive patients was 35.7%, which was higher than that in TGAb-negative patients (7.7%). The positive rate of thyroid function in TPOAb-positive patients was 57.1%, higher than 0.9% of those with TPOAb (P <0.05). Gender, age, treatment of interferon and other factors with the incidence of thyroid dysfunction was not statistically significant (P> 0.05). Conclusions The positive baseline of thyroid TPOAb and TGAb is a risk factor for thyroid dysfunction after antiviral treatment and may be used as a monitoring index for adverse thyroid dysfunction in chronic hepatitis C virus antiviral therapy.