The Clinical Significance Of Determinating Serum Thyroid Hormone In Chronic Liver Disease

Objective: Through the detection of serum thyroid hormone in patients with chronic hepatitis B(CHB),primary biliary cholangitis(PBC),alcoholic liver disease(ALD)and related cirrhosis to evaluate the clinical value ?Methods: 1.A total of 122 resident patients were admitted to the affiliated hospital of Qinghai University from November 2016 to November 2017.53 healthy people were enrolled as controls.Chronic liver disease patients divided into non-cirrhotic(n=59)group and cirrhosis group(n=63).Aslo,non-cirrhotic patients were divided into chronic hepatitis B(CHB)group(n=27),primary biliary cirrhosis(PBC)group(n=15)and ALD group(n=17).Cirrhosis patients were divided into chronic hepatitis B(CHB)group(n=15),primary biliary cirrhosis(PBC)group(n=30)and ALD group(n=18)as well.The levels of serum thyroid hormone was test by the chemiluminescent immunoassay.2.To compare the differences in serum thyroid hormone levels between different etiological liver diseases.3.In additon,the cirrhotic patients were divided into A?B and C group according to Child–Pugh classification(CP).Comparing the characteristic of serum thyroid hormone levels in patients between different groups and analyzing the correlation.4.The clinical data were collected and divided into case group and control group according to the occurrence of esophageal and gastric variceal.Compared and analyzed the clinical data and laboratory examinations of the two groups.To find out the risk factors of cirrhosis with esophageal and gastric variceal.Results: 1.Compared with the control group,there was no significant difference in the levels of thyroid hormone among the three groups of non-cirrhotic patients(P>0.05).The levels of thyroid hormone TT3,FT3 among the three groups of cirrhotic patients were significantly lower than that in normal group(P<0.05).The level of TPO-Ab in PCB group of cirrhotic patients was significantly higher than that in normal group(P<0.05).There was no significant difference in the levels of thyroid hormone in three different causes of chronic hepatitis and cirrhotic(P>0.05).2.There was significant difference was founded about the levels of TT3 and FT3 among the the cirrhotic patients which were divided into A?B and C group according to Child–Pugh classification(P<0.05).The TT3 and FT3 level in A group was higher than B group,while the TT3 and FT3 level in B group was higher than C group.There was no significant difference in the levels of TT4,FT4,TSH among the three groups(P>0.05).The TT3,FT3 levels in cirrhosis group were positively correlated with serum albumin levels(rs=0.572,rs=0.646,P<0.05),the TT3,FT3 levels in cirrhosis group were negatively correlated with the severity of ascites and the Prothrombin International Normalization Ratio(rs=-0.444,rs=-0.475,rs=-0.436,rs=-0.292,P<0.05).The TT3 level was negatively correlated with Serum bilirubin level,while there was no correlation between FT3 and Serum bilirubin(P>0.05).3.There was significant difference founded about the levels of TT3 and FT3 among the the cirrhotic patients which were divided into cirrhosis with esophageal and gastric variceal and cirrhosis without esophageal and gastric variceal groups.The cirrhosis with esophageal and gastric variceal patients were divided into light,medium,and severe levels according to their condition.The TT3?FT3 levels in cirrhosis with severe esophageal and gastric variceal patients were lower than cirrhosis with light esophageal and gastric variceal patients and cirrhosis without esophageal and gastric variceal patients(P<0.05).The FT3 levels in cirrhosis with medium esophageal and gastric variceal patients were lower than cirrhosis without esophageal and gastric variceal patients(P<0.05).While the TT3 levels in cirrhosis with severe esophageal and gastric variceal patients were lower than cirrhosis with medium esophageal and gastric variceal patients(P<0.05).The TT3?FT3 levels in cirrhosis with esophageal and gastric variceal patients were negatively correlated with the severity of esophageal and gastric varices(rs=-0.552,rs=-0.525,P<0.05).Conclusions: 1.The changes of thyroid hormone levels in patients with chronic liver disease may be related to the severity of liver disease regardless of the etiology.2.The detection of TT3 and FT3 levels in patients with cirrhosis may be used as a basis for clinical judgment of liver reserve function.3.The examination of TT3.FT3 was beneficial to the judgment of the severity of esophageal and gastric varices.