慢性丙型病毒性肝炎治疗中发生甲状腺功能异常的危险因素

发布时间：2018-06-21 16:10

本文选题：慢性丙型肝炎 + 抗病毒治疗　；参考：《中国临床药理学杂志》2015年16期

【摘要】：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%(P0.05)。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(P0.05)。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。
[Abstract]:Objective to investigate the risk factors of thyroid dysfunction in antiviral therapy of chronic viral hepatitis C. Methods 131 patients with chronic hepatitis C were treated by subcutaneous injection of Peg-IFN- 伪 -2aFG Peg-IFN- 伪 -2a1 once a week, combined with ribavirin 15 mg / kg once a day for 48 weeks. The levels of free thyroid hormone FT4, free triiodothyronine FT3, thyroid stimulating hormone TSH1, and anti-thyroid peroxidase antibody (TPOAbA) and anti-thyroglobulin antibody (TGAbb) were measured within 2 weeks before treatment and 48 weeks after treatment. Results after treatment, the incidence of thyroid dysfunction was 10.69%. The rate of thyroid dysfunction in patients with TGAb baseline positive was 35.70.The rate was higher than that in TGAb negative patients (7.7g / kg) and the rate of thyroid dysfunction was 57.1% (P < 0.05). There was no significant correlation between sex, age, duration of interferon use and thyroid dysfunction (P 0.05). Conclusion thyroid TPOAb-TGAb baseline positive is a risk factor for thyroid dysfunction after antiviral therapy. It can be used as a monitoring index for adverse reactions of thyroid dysfunction in chronic hepatitis C antiviral therapy.
【作者单位】：上海交通大学医学院附属瑞金医院感染科;三明市中西医结合医院肝病专科;
【分类号】：R512.63

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