陈开兰，李维珍（贵州航天医院检验科，贵州遵义563000）

·论著·

乙型肝炎肝硬化患者抗病毒治疗后HBV-DNA含量与甲状腺激素的相关性

陈开兰，李维珍
（贵州航天医院检验科，贵州遵义563000）

目的探讨乙型肝炎（乙肝）肝硬化患者抗病毒治疗后乙肝病毒（HBV）-DNA含量与甲状腺激素水平的相关性。方法选取该院2013年1月至2015年6月收治的96例抗病毒治疗乙肝肝硬化患者作为病例组，选取同期该院40例健康体检者作为健康对照组。对比抗病毒治疗前病例组与对照组甲状腺激素水平、病例组治疗前后甲状腺激素水平变化、HBV-DNA转阴患者与未转阴患者甲状腺激素水平。结果抗病毒治疗前，病例组患者甲状腺激素水平显著低于健康对照组，差异有统计学意义（P＜0.05）；与治疗前比较，病例组患者抗病毒治疗后三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、甲状腺素（T4）、游离甲状腺素（FT4）水平升高，促甲状腺激素（TSH）降低，差异均有统计学意义（P＜0.05）；HBV-DNA转阴患者较未转阴患者T3、T4、FT3、FT4水平升高，TSH降低，差异均有统计学意义（P＜0.05）。结论乙肝肝硬化患者抗病毒治疗后甲状腺激素水平与HBV-DNA含量有一定相关性，抗病毒治疗可以改善患者甲状腺激素失衡状态。

肝炎，乙型；肝硬化；甲状腺激素类/血液；肝炎病毒

【Abstract】Objective To investigate the correlation between HBV-DNA leveland thyroid hormone levelafter antiviral therapy in the patientswith hepatitis B induced cirrhosis.Methods Ninety-six cases of hepatitis B induced cirrhosis treated by antiviral therapy in our hospital from January 2013 to June 2015 were selected as the case group and contemporaneous 40 individuals undergoing the healthy physical examination were selected as the control group.The thyroid hormone levelswere compared between before antiviral therapy in the case group and the control group，and the changes of thyroid hormone level in the cases group were compared between before and after treatment.The thyroid hormone levels were compared between the patients with HBV-DNA negative conversion and the patients with HBV-DNA non-negative conversion.Results The thyroid hormone levelsbefore treatment in the case group were significantly lower than those in the healthy control group with statistical difference （P＜0.05）；compared with before treatment，the levels of T3，FT3，T4 and FT4 after treatment in the case group were increased，while the TSH levelwas decreased，the differences were statistically significant（P＜0.05）；the T3，T4，FT3 and FT4 levels in the patients with HBV-DNA negative conversion were increased compared with the patients with HBV-DNA non-negative conversion，while the TSH level was decreased，the differencewasstatistically significant（P＜0.05）.Conclusion The levelsof thyroid hormone after antiviral therapy in the patients with hepatitis Binduced cirrhosis are correlated with the levels of HBV-DNA in some extent and anti-viral therapy can improve the thyroid hormone imbalance status.

【Key words】HepatitisB；Liver cirrhosis；Thyroid hormones/blood；Hepatitisviruses

乙型肝炎病毒（HBV）感染后可导致肝细胞损伤、功能减退，严重者导致肝纤维化进展，进而出现乙型肝炎（乙肝）肝硬化，给社会和家庭造成严重负担［1］。肝脏是甲状腺激素降解转化、代谢灭活的主要器官，是甲状腺激素发挥生理功能的关键场所，肝功能受损往往会导致血清甲状腺激素的异常变化，引起多种并发症的发生，对患者预后形成影响。……