[肝硬化门诊患者隐匿性甲状腺功能障碍]。

Nayeli Ortiz-Olvera, Araceli Muñoz-Bautista, Mario Molina-Ayala, Rita A Gómez-Díaz, Segundo Morán-Villota
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引用次数: 0

摘要

背景:肝硬化患者的甲状腺功能发生了一些变化:在肝硬化(LC)患者中发现了甲状腺功能的一些改变:材料与方法:一项横断面研究:横断面研究。测量血清促甲状腺激素(TSH)和游离四碘甲状腺原氨酸(T4)水平,并根据肝硬化病因、性别、终末期肝病模型(MELD)评分和Child-Pugh(C-P)分级进行比较:最常见的病因是丙型肝炎病毒(45%),其次是非酒精性脂肪肝(17%)。我们发现 36% 的患者存在甲状腺功能障碍。最常见的病变是亚临床甲状腺功能减退症(34%)。酒精性肝硬化患者出现亚临床甲状腺功能减退的频率最高(45%),自身免疫性疾病导致的肝硬化患者和酒精性肝硬化患者的促甲状腺激素水平较高:我们发现甲状腺激素水平、年龄、MELD评分或C-P之间没有相关性。我们的研究结果表明,隐匿性原发性甲状腺功能障碍在门诊肝硬化患者中很常见,与年龄、病因或肝储备功能无关。亚临床甲状腺功能减退症是主要的病变,在酒精诱导的肝硬化患者中更为常见。要了解亚临床甲减对肝硬化患者临床进展的影响,还需要进行纵向研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Occult thyroid dysfunction in outpatients with liver cirrhosis].

Background: Several alterations in thyroid function have been identified in patients with liver cirrhosis (LC).

Objective: To carry out a thyroid disease screening in adult patients with LC.

Material and methods: A cross-sectional study. Serum levels of thyroid-stimulating hormone (TSH) and free-tetraiodothyronine (T4) were measured, and compared according to etiology of the cirrhosis, sex, model of end-stage liver disease (MELD) score, and Child-Pugh (C-P) class.

Results: The most frequent etiology was hepatitis C virus (45%), followed by non- alcoholic fatty liver-disease (17%). We found thyroid dysfunction in 36% of the patients. The most frequent alteration was subclinical hypothyroidism (34%). Patients with alcohol-induced cirrhosis had the highest frequency of subclinical hypothyroidism (45%) and TSH levels were higher in patients with cirrhosis due to autoimmune disease and in those with alcohol-induced cirrhosis.

Conclusion: We found no correlation between thyroid hormone levels, age, MELD score, or C-P. Our results showed that occult primary thyroid dysfunction is frequent in outpatients with LC, regardless of age, etiology, or liver reserve. Subclinical hypothyroidism was the main alteration and presented more frequently in patients with alcohol-induced cirrhosis. Longitudinal studies are needed to know the impact of subclinical hypothyroidism on the clinical progression of patients with cirrhosis.

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