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病毒性肝炎干扰素治疗与甲状腺疾病患病的临床分析

作者：胡虹英李新刚崔雅菁马伟杰邢卉春谢雯

单位：首都医科大学附属北京地坛医院

关键词：病毒性肝炎干扰素甲状腺疾病

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出版年,卷(期):页码：2015,7(1):59-62

摘要：

摘要：目的研究病毒性肝炎进行干扰素治疗前和治疗中甲状腺疾病的临床特点及相关危险因素。方法临床收集慢性病毒性肝炎（乙型和丙型）患者应用干扰素治疗共185例，进行跟踪随访1年，对其临床资料进行统计学分析，探索病毒性肝炎与甲状腺疾病发病的相关因素。结果 185例患者中，男性115例，女性70例，慢性乙型病毒性肝炎（乙型肝炎组）98例，慢性丙型病毒性肝炎（丙型肝炎组）87例。干扰素治疗前甲状腺异常患者共27例，男性4例，女性23例，基线时甲状腺异常的发生率男性3.5%（4/115），女性32.9%（23/70），女性高于男性；治疗前乙型肝炎组甲状腺异常7例（7.1%），丙型肝炎组20例（23%），丙型肝炎组患病率高于乙型肝炎组；甲状腺过氧化物酶抗体（TPOAb）浓度也表现为丙型肝炎组高于乙型肝炎组；且差异均有统计学意义。干扰素治疗中甲状腺功异常75例，男性19例，女性56例，甲状腺异常发生率分别是男性16.5%，女性80.0%，女性明显高于男性；治疗中乙型肝炎组甲状腺异常17例（17.3%），丙型肝炎组58例（66.7%）丙型肝炎组高于乙型肝炎组，TPOAb浓度丙型肝炎组明显高于乙型肝炎组，差异均有统计学意义。Logistic多元回归分析结果显示，性别（女性）、病毒性肝炎类型（丙型肝炎）、甲状腺过氧化物酶抗体阳性是发生甲状腺异常的独立危险因素。结论慢性丙型病毒性肝炎合并甲状腺过氧化物酶抗体阳性的患者，干扰素治疗后更易出现甲状腺疾病，女性尤为多见。

Abstract: Objective To investigate the clinical characteristics and risk factors for thyroid disease in patients before and during interferon treatment in viral hepatitis patients. Methods Total of 185 patients with chronic hepatitis B and chronic hepatitis C who received interferon treatments were enrolled. All patients took one year follow-up. Clinical data was analyzed to elucidate the relationship between IFN therapy and thyroid dysfunction. Results The 98 cases of chronic hepatitis B (CHB group) and 87 cases of chronic hepatitis C patients (CHC group) were enrolled. The 27 patients (14.6%) had thyroid dysfunction before IFN treatment. Less male patients (3.5%, 4/115) had thyroid dysfunction before IFN therapy than female patients (32.9%, 23/70). More CHC patients 23.0% (20/87) had thyroid dysfunction before IFN therapy than CHB patients (7.1%, 7/98). And more CHC patients were TPOAb positive before IFN treatment than CHB patients. More female patients (80.0%, 56/70) had thyroid dysfunction during IFN therapy than male patients (16.5%, 19/115). More CHC patients (66.7%, 58/87) had thyroid dysfunction during IFN therapy than CHB patients (17.3%, 17/98). And more CHC patients were TPOAb positive during IFN treatment than CHB patients. Logistic regression indicates that female, chronic hepatitis C and TPOAb positive are independent risk factors for thyroid dysfunction. Conclusions Female CHC patients with TPOAb positive are more likely to have thyroid disease.

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