摘要
目的 探讨急性失代偿期肝硬化患者甲状腺激素水平与Child-Pugh分级、CLIF-C AD评分之间的相关性。方法 回顾收集2020年1月至2024年12月大理大学第二附属医院收治的100例急性失代偿期肝硬化患者作为研究组，选取同时期正常健康体检者100例作为对照组。收集并分析两组患者的临床资料和实验室指标。符合正态分布的计量资料两组间采用t检验，多组间比较采用方差分析；不符合正态分布的计量资料组间比较采用Mann-Whitney U检验。对急性失代偿期肝硬化患者甲状腺激素水平与Child-Pugh分级、CLIF-C AD评分进行Pearson和Spearman相关性分析。结果 研究组的T3、FT3、TSH水平，均明显低于对照组，P均＜0.05；根据病因分组，自身免疫性肝硬化组T4水平高于病毒性肝硬化组、酒精性肝硬化组、不明原因肝硬化组，P＜0.05；急性失代偿事件中，显性腹水组TSH水平明显高于消化道出血组的，P＜0.05；根据Child-Pugh分级分组，Child-PughA级FT3水平明显高于B级和C级，且Child-PughB级FT3水平高于C级，P均＜0.05；根据CLIF-C AD评分分组，低危组FT3水平高于中危组和高危组，中危组FT4水平明显高于高危组，P均＜0.05。相关性分析显示，肝功能Child-Pugh分级与FT3呈负相关（r=-0.460,P＜0.05），急性失代偿期肝硬化患者CLIF-C AD分组与FT3呈负相关（r=-0.410,P＜0.05）。结论 急性失代偿期肝硬化患者伴有甲状腺激素水平的异常变化，血清FT3水平与其病情严重程度及预后关系密切。
关键词： 肝硬化；急性失代偿；甲状腺激素；肝功能评分；相关性
Abstract
Abstract：Objective To explore the correlation between thyroid hormone levels and Child-Pugh classification and CLIF-C AD score in patients with acute decompensated cirrhosis.Methods 100 patients with acute decompensated cirrhosis admitted to the Second Affiliated Hospital of Dali University from January 2020 to December 2024 were retrospectively collected as the study group, and 100 cases of normal healthy medical checkups in the same period were selected as the control group.The clinical data and laboratory indexes of the two groups were collected and analyzed.The t-test was used between two groups for the measurements that conformed to normal distribution, and the ANOVA was used for the comparison between multiple groups; the Mann-Whitney U test was used for the comparison between groups for the measurements that did not conform to normal distribution.Pearson and Spearman correlation analyses were performed to analyze the thyroid hormone levels with Child-Pugh classification and CLIF-C AD score in patients with acute decompensated cirrhosis.Results T3, FT3, and TSH levels in the study group were significantly lower than those in the control group, all P<0.05; according to the etiologic grouping, T4 levels in the autoimmune cirrhosis group were higher than those in the viral cirrhosis group, the alcoholic cirrhosis group, and the cirrhosis of undetermined origin group, all P<0.05; in the acute decompensated events, the TSH levels in the dominant ascites group were significantly higher than those in the gastrointestinal bleeding group, all P<0.05; according to theChild-Pugh grading grouping, Child-Pugh grade A FT3 level was significantly higher than grade B and C, and Child-Pugh grade B FT3 level was higher than grade C, both P<0.05; according to CLIF-C AD score grouping, the low-risk group had a higher level of FT3 than the intermediate-risk and high-risk groups, and the intermediate-risk group had a significantly higher level of FT4 than the high-risk group, both P<0.05.Correlation analysis showed that liver function Child-Pugh grading was negatively correlated with FT3 (r=-0.460,P<0.05), and CLIF-C AD grouping in patients with acute decompensated cirrhosis was negatively correlated with FT3 (r=-0.410,P<0.05).Conclusion Patients with acute decompensated cirrhosis were accompanied by abnormal changes in thyroid hormone levels, and serum FT3 levels were closely related to the severity of their disease and prognosis.
Key words： Liver Cirrhosis; Acute decompensation; Thyroid hormone; Liver function score; Correlation
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