graves病患者甲亢性肝损害及其相关因素分析

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1、Graves病患者甲亢性肝损害及其相关因素分析作者：田竹芳，施秉银，赵新，高珊，胡文华【摘要】　　目的探讨Graves病(GD)患者甲亢性肝损害的发生率及其相关因素。方法GD患者280例,分为未治组(131例)和经治组(149例)，检测肝功能指标、血清甲状腺激素水平、甲状腺自身抗体。对其肝功能损害的发生率、临床特点及相关因素进行分析。结果在未治组甲亢性肝功能损害的发生率为70.99%，经治组为61.07%；甲亢性肝功能损害最常见的异常指标是碱性磷酸酶(ALP)增高，未治组、经治组分别为57.3%、51.0%；血清谷丙转氨酶(ALT)异

2、常在两组的发生率分别为28.2%、21.5%；血清谷草转氨酶(AST)异常在两组的发生率分别为18.3%、15.4%；总胆红素异常在两组的发生率分别为21.4%、20.1%；谷酰胺转肽酶(GGT)异常的发生率未治组和经治组分别为10.7%、4.7%；甲亢性肝功能损害的发生与病程、甲状腺疾病家族史、性别、TGAb水平、TMAb水平无关，与年龄、甲状腺激素水平有关。结论GD患者甲亢性肝损害较常见，肝功能损害最常见的异常指标是ALP、ALT，甲亢性肝功能损害与甲状腺激素水平、年龄有关。【关键词】Graves病；肝功能；甲状腺激素；TGAb；

3、TMAb　　ABSTRACT:ObjectiveToinvestigatetheincidenceandthepossibleriskfactorsofhepaticdysfunctioninpatients10withGravesdisease(GD).MethodsTotally280outpatientswithhyperthyroidism(causedbyGD)weredividedintwogroups:untreatedgroup(131patients)andtreatedgroup(149patients).The

4、hepaticfunction,serumthyroidhormone,TGAbandTMAbweredetectedforanalysisoftheincidence,clinicalcharacteristicsandcorrelativefactorsofthehepaticdysfunction.ResultsPatientswhohadatleastoneabnormalresultofliverfunctiontestaccountedfor70.99%inuntreatedgroupand61.07%intreatedg

5、roup.Themostcommonabnormalhepaticfunctionparameterinpatientswiththyrotoxichepaticlesionwasincreasedalkalinephosphateenzyme(ALP),whichwas57.3%inuntreatedgroupand51.0%intreatedgroup.Abnormalitiesofalaninetransaminase(ALT),aspartatetransaminase(AST),gammaglutamyltyanspept

6、idase(GGT)andtotalbilirubin(TBIL)were28.2%(37/131),18.3%(24/131),10.7%(14/131)and21.4%(28/131)inuntreatedgroupand21.5%(32/149),15.4%(23/148),4.7%(7/149)and20.1%(30/149)intreatedgroup,respectively.Thepossibilityofthyrotoxichepaticdysfunctionwascorrelatedwiththepatientsa

7、geandFT3andFT4levels,butnotwiththegenesisandcourseofdisease,sex,familyhistoryofhyperthyroidism,orlevelsofTGAbandTMAb.ConclusionAbnormalresultsofliverfunctiontestare10commominpatientswithhyperthyroidism.Increasedalkalinephosphateenzymeandalaninetransaminasearethemostcomm

8、onabnormalhepaticfunctionparameters;thepossibilityofthyrotoxichepaticdysfunctioniscorrelatedwithpatientsagean