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目的探讨肝硬化患者血清甲状腺激素水平的变化与肝硬化Child-Pugh分级的关系。方法选择2005年10月至2007年12月中山市黄圃人民医院门诊、内科就诊的患者98例,经血清生化学、血清AFP、HA、PⅢP、Ⅳ-C及LN检测以及B超、X-CT等影像学检查得以证实为肝硬化。同期查体健康者30名作为对照组。检测两组T3、T4、FT3、FT4、sTSH、血清白蛋白、凝血酶原时间和总胆红素的关系等生化指标,比较T3、T4、FT3、FT4、sISH的水平与肝硬化Child-Pugh分级的关系。结果肝硬化组的血清T3、T4、FT3、FT4与对照组相比均有下降,相对应指标间的差异有统计学意义(P<0.05);肝硬化组血清sTSH水平与对照组相比均无差异有统计学意义(P>0.05),且T3、T4、FT3、FT4的下降程度与肝硬化Child-Pugh分级呈正相关。结论肝硬化患者血清甲状腺激素水平的变化可作为判断疾病病情一个有效指标,通过血清甲状腺激素水平的监测可判断疾病状况、治疗效果及预后。
Objective To investigate the relationship between serum thyroid hormone level and Child-Pugh classification of cirrhosis patients with cirrhosis. Methods From October 2005 to December 2007, Zhongshan Hospital of Huangpu People’s Hospital outpatient, medical treatment of 98 patients, the serum biochemical, serum AFP, HA, PⅢP, Ⅳ-C and LN detection and B-, X- CT and other imaging studies confirmed liver cirrhosis. The same period physical examination 30 as a control group. The biochemical indexes such as T3, T4, FT3, FT4, sTSH, serum albumin, prothrombin time and total bilirubin were detected. The levels of T3, T4, FT3, FT4 and sISH were compared with those of Child- Pugh Hierarchical relationship. Results The serum levels of T3, T4, FT3 and FT4 in cirrhotic patients decreased compared with the control group, and there was significant difference between the corresponding indexes (P <0.05). The levels of serum sTSH in cirrhosis group were significantly lower than those in the control group No difference was statistically significant (P> 0.05), and the decline of T3, T4, FT3, FT4 and cirrhosis Child-Pugh grade was positively correlated. Conclusion The change of serum thyroid hormones in patients with cirrhosis can be used as an effective index to judge the disease status. The monitoring of serum thyroid hormone level can judge the disease status, treatment effect and prognosis.