熊去氧胆酸治疗原发性胆汁性胆管炎患者血清甲状腺激素水平变化

实用肝脏病杂志2019年9月第22卷第5期J Prac Hepatol ，Sept.2019.Vol.22No.5

··熊去氧胆酸治疗原发性胆汁性胆管炎患者血清

甲状腺激素水平变化*

边新渠，陈杰，刘燕敏，黄云丽，任美欣，张小丹，杜晓菲，黄春洋，廖慧钰，单晶，韩莹

【摘要】目的

探讨应用熊去氧胆酸（UDCA ）治疗原发性胆汁性胆管炎患者血清甲状腺激素水平的变化。方

法2016年1月～2017年6月我院治疗的原发性胆汁性胆管炎患者70例和原发性胆汁性肝硬化患者95例，另选20例健康人作为对照组。给予患者UDCA 治疗3月，检测治疗前后血清甲状腺激素水平变化。结果

在治疗3个月末，两组患者肝功能指标得到改善，除胆管炎患者血清ALP 和GGT 水平仍显著高于肝硬化患者外，其他肝功能指标比较，差异无统计学意义（P >0.05）；治疗前，胆管炎患者血清总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平分别为1.6±0.2nmol/L 、3.2±0.4pmol/L 、95.6±28.7nmol/L 和10.3±3.6pmol/L ，肝硬化患者分别为1.1±0.2nmol/L 、3.0±0.3pmol/L 、88.2±26.7nmol/L 和9.7±2.5pmol/L ，均显著低于健康人【分别为（2.5±0.5nmol/L 、4.7±0.8pmol/L 、115.7±31.6nmol/L 和13.8±4.1pmol/L ，P <0.05】，两组患者血清促甲状腺素（TSH ）水平与健康人比，差异无统计学意义【分别为（2.9±0.5mIU/L 和2.9±0.7mIU/L 对3.3±0.6mIU/L ，P >0.05】；在治疗3个月末，胆管炎患者血清TT3、FT3、TT4和FT4水平分别为2.4±0.6nmol/L 、4.5±0.8pmol/L 、108.2±36.2nmol/L 和12.9±3.5pmol/L ，较治疗前显著上升，已与健康人无统计学差异（P >0.05），而肝硬化患者血清TT3、FT3、TT4和FT4水平分别为1.2±0.3nmol/L 、3.4±0.4pmol/L 、93.7±29.8nmol/L 和9.9±3.1pmol/L ，无明显改善，仍显著低于健康人（P <0.05）。结论

原发性胆汁性胆管炎患者经熊去氧胆酸治疗后，血清甲状腺激素水平可获得改善，因此应该早期诊断、早期治疗。

【关键词】原发性胆汁性胆管炎；肝硬化；熊去氧胆酸；甲状腺激素；治疗

DOI ：10.3969/j.issn.1672-5069.2019.05.026

Serum thyroid hormone level changes in patients with primary biliary cholangitis

receiving ursodeoxy-cholic acid therapy Bian Xinqu ，Chen Jie ，Liu Yanmin ，et al.Department of Immunology and Hepatology ，You ’an Hospital ，Capital Medical University ，Beijing 100069，China

【Abstracts 】Objective To investigate serum thyroid hormone level changes in patients with primary biliary cholangitis （PBC ）receiving ursodeoxycholic acid therapy.Methods 70patients with primary biliary cholangitis ，

95with primary liver cirrhosis ，and 20healthy persons were recruited in our hospital between January 2016and June 2017，and all patients were treated with ursodeoxycholic acid （UDCA ）for three months.Serum biochemical tests and thyroid hormone levels were detected before and after 3month treatment.Results At the end of 3month treatment ，the liver function tests in patients with cholangitis and liver cirrhosis were improved ；at presenta -

tion ，serum TT3，FT3，TT4and FT4levels in patients with liver cirrhosis were 1.6±0.2nmol/L ，3.2±0.4pmol/L ，95.6±28.7nmol/L and 10.3±3.6pmol/L ，and in patients with cholangitis were 1.1±0.2nmol/L ，3.0±0.3pmol/L ，88.2±26.7nmol/L and 9.7±2.5pmol/L ，all significantly lower than 2.5±0.5nmol/L ，4.7±0.8pmol/L ，115.7±31.6nmol/L and 13.8±4.1pmol/L in healthy persons （P <0.05），while serum TSH levels in the three groups were not significantly different （2.9±0.5mIU/L and 2.9±0.7mIU/L vs.3.3±0.6mIU/L ，respectively ，P >0.05）；at the end of 3month treatment ，serum TT3，FT3，TT4and FT4levels in patients with cholangitis were 2.4±0.6nmol/L ，4.5±0.8pmol/L ，108.2±36.2nmol/L and 12.9±3.5pmol/L ，not significantly different as compared to those in healthy persons ，while they were 1.2±0.3nmol/L ，3.4±0.4pmol/L ，93.7±29.8nmol/L and 9.9±3.1pmol/L in patients with liver cirrhosis ，still significantly lower than those in healthy persons （P <0.05）.Conclusion The thyroid hormone levels de -crease and might be improved after the treatment of ur -sodeoxycholic acid in patients with primary biliary cholangitis ，which should start as early as possible.【Key words 】Primary biliary cholangitis ；Liver cirrhosis ；Ursodeoxycholic acid ；Thyroid hormones ；Therapy *基金项目：北京市丰台区卫生系统科研项目（编号：2017-62）

作者单位：100069北京市首都医科大学附属北京佑安医院肝

病免疫科

第一作者：边新渠，男，36岁，硕士研究生。主要从事自身免疫性

肝病防治研究

通讯作者：韩莹，E-mail:gladyshanying@ ·肝硬化·

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