昆明理工大学附属医院/云南省第一人民医院内分泌代谢科,昆明 650000
Received:12 September 2022,
Revised:2022-11-01,
Accepted:20 March 2023,
Published:28 April 2023
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张雅婷,牛奔,苏恒.丙型肝炎与甲状腺功能异常相关性的临床研究[J].重庆医科大学学报,2023,48(4):457-461.
Zhang Yating,Niu Ben,Su Heng.Clinical study on the correlation between hepatitis C and thyroid dysfunction[J].Journal of Chongqing Medical University,2023,48(4):457-461.
张雅婷,牛奔,苏恒.丙型肝炎与甲状腺功能异常相关性的临床研究[J].重庆医科大学学报,2023,48(4):457-461. DOI: 10.13406/j.cnki.cyxb.003213.
Zhang Yating,Niu Ben,Su Heng.Clinical study on the correlation between hepatitis C and thyroid dysfunction[J].Journal of Chongqing Medical University,2023,48(4):457-461. DOI: 10.13406/j.cnki.cyxb.003213.
目的
2
探讨慢性丙型肝炎(chronic hepatitis C,CHC)和甲状腺功能异常(thyroid dysfunction,TD)的相关性以及慢性丙型肝炎患者中TD的预测因素。
方法
2
选取2018年6月至2021年12月在云南省第一人民医院确诊为CHC的患者95例,根据其血清丙型肝炎病毒(hepatitis C virus,HCV)-RNA表达水平,分为低HCV-RNA组(
<
10
5
IU/mL)(37例)和高HCV-RNA组(
>
10
5
IU/mL)(47例),随机选取同期至本院体检的健康者41例;收集相关实验室指标,包括促甲状腺激素(thyroid stimulating hormone,TSH)、甲状腺素(thyroxine,T4)、三碘甲状腺原氨酸(triiodothyronine,T3)、游离甲状腺素(free thyroxine,FT4)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)、总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、总蛋白(total protein,TP)、白蛋白(albumin,ALB)、球蛋白(globulin,GLB)、尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)、血糖(glucose,G),来探讨CHC患者的甲状腺激素及相关生化指标与HCV-RNA载量的关系。根据其是否合并TD分为单纯丙肝组和丙肝合并TD组,选取丙肝合并TD组14例,单纯丙肝组15例,随机选取同期健康体检者15例作为对照组,对3组病例的实验室指标进行统计学分析。
结果
2
95例慢性丙型肝炎患者中,合并TD者共15例,检出率为15.79%。对照组、低HCV-RNA组、高HCV-RNA组3组相比,T4、T3、FT4、FT3、AST、ALT、DBIL、ALB、GLB差异具有统计学意义(
P
<
0.05),对有意义的指标进行无序多元logistic回归分析显示,低表达组与对照组相比,GLB(
OR
=1.379,95%CI=1.060~1.5793,
P
<
0.05)可能是病毒载量升高的预测因素;高表达组与对照组相比,GLB(
OR
=1.425,95%CI=1.094~1.856,
P
<
0.05)可能是预测因素;高表达组与低表达组相比,FT3(
OR
=3.543,95%CI=1.472~8.356,
P
<
0.05)可能是预测因素。对照组、单纯丙肝组、丙肝合并甲状腺功能障碍组3组相比,TSH、FT4、FT3、AST、ALT、ALP、ALB、GLB差异具有统计学意义(
P
<
0.05)。
结论
2
慢性丙型肝炎患者的病毒载量水平与甲状腺激素水平有关,对临床有一定指导意义。
Objective
2
To explore the correlation between chronic hepatitis C(CHC) and thyroid dysfunction(TD),and the predictors of TD induced by hepatitis C.
Methods
2
A total of 95 patients diagnosed with CHC in The First People's Hospital of Yunnan Province from June 2018 to December 2021 were selected, and they were divided into low hepatitis C virus(HCV)-RNA group(
<
10
5
IU/mL) (37 cases) and high HCV-RNA group(
>
10
5
IU/mL)(47 cases),according to their HCV-RNA expression level. And 41 healthy controls were selected randomly from whom made the physical examination in our hospital at the same period. Relevant laboratory indicators, including thyroid stimulating hormone(TSH),thyroxine(T4),triiodothyronine(T3),free thyroxine(FT4),free triiodothyronine (FT3),aspartate transaminase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL),total protein(TP),albumin(ALB),globulin(GLB),blood urea nitrogen(BUN),creatinine(Cr),and glucose(G),were collected to explore the relationship between thyroid hormone and related biochemical indicators and HCV-RNA load in CHC patients. According to whether they had TD or not, they were divided into hepatitis C group and hepatitis C combined with TD group. Fourteen cases of hepatitis C combined with TD group and 15 cases of hepatitis C group were selected,and 15 cases of healthy people were randomly selected as the control group. The laboratory indicators of the three groups were statistically analyzed.
Results
2
Among 95 patients with CHC,15 patients were complicated with TD,and the detection rate was 15.79%. Compared with the control group,the low HCV-RNA group and the high HCV-RNA group were significantly different in T4,T3,FT4,FT3,AST,ALT,DBIL,ALB and GLB(
P
<
0.05). Disordered multiple logistic regression analysis sho
wed that GLB(
OR
=1.379,95%CI=1.060-1.5793,
P
<
0.05) might be a predictor of increased viral load. Compared with the control group,GLB(
OR
=1.425,95%CI=1.094-1.856,
P
<
0.05) could be a predictor, FT3 (
OR
=3.543, 95%CI=1.472-8.356,
P
<
0.05) could be a predictor. There were significant differences in TSH,FT4,FT3,AST,ALT,ALP,ALB and GLB among the control group, hepatitis C group and hepatitis C combined with TD group(
P
<
0.05).
Conclusion
2
The level of viral load in patients with CHC is related to the level of thyroid hormone, which has certain guiding significance for clinical practice.
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