The Clinical Analysis Of Acute Viral Hepatitis To Hyperthyroidism With Hepatic Functional Impairment

Objective:We analyze the clinical characteristic of acute viral hepatitis, hyperthyroidism with hepatic functional impairment and acute viral hepatitis combined hyperthyroidism, explore the similarities, differences and connection of acute viral hepatitis and hyperthyroidism with hepatic functional impairment about hepatic functional and thyroid function, in order to provide scientific instruction for hepatic functional impairment about clinical diagnosis and treatment.Method:We select 24 cases of acute viral hepatitis patients (hepatitis group),32 cases of hyperthyroidism with hepatic functional impairment (hyperthyroidism with hepatic functional impairment group) and 10 cases of acute viral hepatitis combined hyperthyroidism (hepatitis combined hyperthyroidism group) as research object,20 cases of healthy people as control group. We analyze the correlation clinical information of research object, analyze and compare the similarities and differences about their every index of hepatic functional, thyroid function and clinical feature, as well as analyze the internal relation of them.Results:1.The comparison about related index of hepatic functional and course of treatment:1.1 The comparison of abnormal probability about related index of hepatic functional and course of treatment in the three groups:The ratio of hyperthyroidism with hepatic functional impairment with rising ALT, AST and ALP is lower than hepatitis group (P< 0.0167); the abnormal rate of hyperthyroidism with hepatic functional impairment group about ALB, TBIL and PTA is lower than hyperthyroidism with hepatic functional impairment group and hepatitis combined hyperthyroidism group (P<0.0167); in the three groups, the hepatitis combined hyperthyroidism group is the highest about the abnormal ratio of ALP, GGT, ALB and PTA, and the course of treatment is the longest.1.2 The comparison about the level about index of abnormal hepatic functional in the three groups of patients:The ALT and AST of hyperthyroidism with hepatic functional impairment group is lower than hepatitis group and hepatitis combined hyperthyroidism group (P< 0.05); but there is no statistical significance about ALP and GGT (P>0.05); the ALB of hepatitis combined hyperthyroidism group is the lowest, but the TBIL is the highest,there is statistical significance compared to other two groups (P< 0.05). The TBIL, DBIL and IBIL of the three groups is all rised, the average value of DBIL divided by the average value of TBIL is the highest (72.64%).2.The characteristic, distinction and relation of thyroid function:The T4 of hepatitis group is increased (P<0.05),while the T3 and TSH have no obvious change (P>0.05), The T3 and T4 of the hyperthyroidism with hepatic functional impairment group and hepatitis combined hyperthyroidism group are remarkable increased (P<0.01), while the TSH is remarkable declined (P<0.01). The T3 and T4 of hepatitis group is remarkable lower than the hyperthyroidism with hepatic functional impairment group and hepatitis combined hyperthyroidism group (P<0.01), while the TSH is remarkable higher than them (P<0.01)3.The comparison about clinical symptoms and signs of hepatic functional impairment in the three groups of patients:the occurring rate of hyperthyroidism with hepatic functional impairment group about poor appetite, anaerobic oil and hepatomegaly is lower than hepatitis group (P<0.0167); The occurring rate of hyperthyroidism with hepatic functional impairment group about naupathia, vomit, and jaundice is lower hepatitis group and hepatitis combined hyperthyroidism group (P<0.0167); The occurring rate of hepatitis combined hyperthyroidism group about naupathia, vomit, pruritus cutanea, jaundice and diarrhea is the highest.4.The comparison about correlated clinical symptoms and signs of thyroid in the three groups of patients:The patients of hepatitis group all lack correlated clinical symptoms and signs of thyroid; The patients of hyperthyroidism with hepatic functional impairment group and hepatitis combined hyperthyroidism group all have varying degrees about correlated clinical symptoms and signs of thyroid.Conclusions:1. The hepatic functional impairment of hyperthyroidism with hepatic functional impairment is often lighter than acute hepatitis, when appear jaundice, main is cholestatic jaundice.2. The acute viral hepatitis patients can appear the change of serum levers of thyroid hormone, it maybe remind the state of illness deteriorate, and prognosis turns into worsening.3.when the hepatitis combines hyperthyroidism, hyperthyroidism and hepatitis influence each other, leading to aggravate state of an illness.