| Objective: This study aims to investigate the secreting characteristics and clinical significance of thyroid hormone in different patients with hepatitis b virus-related liver diseases retrospective analysis in patients in order to provide the basis for clinical evaluation of the patient's condition.Methods: A total of 234 patients with hepatitis B virus-related liver diseases were retrospectively selected,who were treated in the Affiliated Hospital of Southwest Medical University from August 2013 to December 2019,including 143 patients developing to cirrhosis,91 patients not developing to cirrhosis,63 patients with liver failure and 171 patients without liver failure.A total of 122 healthy controls with matching sex and age were enrolled in the control group.The general data,liver function,coagulation function,thyroid hormones,antibody indexes and evaluation of liver imaging of these subjects were collected.Results: The levels of FT3,FT4 and TG in the HBV group were lower than those in the control group,and the level of TSH and the positive rates of TPOAb,TGAb and TRAb were higher than those in the healthy group.The difference was statistically significant(P<0.05).FT3 and TG of severe CHB patients were lower than those of moderate CHB patients,mild CHB patients and controls;TSH was significantly higher than that of moderate CHB patients,mild CHB patients and controls;and FT4 was lower than that of mild CHB patients and controls.The difference was statistically significant(P<0.05).FT3 and FT4 of moderate CHB patients were lower than those of mild CHB patients and controls,and TSH was higher than that of mild CHB patients and controls.The difference was statistically significant(P<0.05).The TG level of moderate CHB patients was lower than that of controls.The difference was statistically significant(P<0.05).FT4 and TG of mild CHB patients were lower than those of controls while TSH was higher than that of controls.The difference was statistically significant(P<0.05).The positive rates of TPOAb,TGAb and TRAb of mild,moderate and severe CHB patients were higher than those of controls.The difference was statistically significant(P<0.05).FT3,FT4 and TG in the liver failure group and non-hepatic failure group were lower than those in the control group,and the positive rates of TSH,TPOAb,TGAb and TRAb were significantly higher than those in the control group.The difference was statistically significant(P<0.05).FT3 and TG in the liver failure group was lower than those in the non-hepatic failure group while TSH was higher than that in the non-hepatic failure group.The difference was statistically significant(P<0.05).FT3,FT4 and TG in the non-cirrhotic group and cirrhosis group were lower than those in the control group,and the positive rates of TSH,TPOAb,TGAb and TRAb were higher than those in the control group.The difference was statistically significant(P<0.05).FT3,FT4 and TG in the cirrhosis group were lower than those in the non-cirrhotic group,and the positive rates of TSH and TRAb were higher than those in the non-cirrhotic group.The difference was statistically significant(P<0.05).FT3 and TG were protective factors of liver failure in CHB patients.The OR value of FT3 was 0.184 and 95% CI was 0.091-0.372;the OR value of TG was 0.963 and 95% CI was 0.933-0.95.The difference was statistically significant(P<0.05).The TSH and age were independent risk factors of cirrhosis in CHB patients.The OR value of TSH was 1.706 and 95% CI was 1.44-2.023;the OR value of age was 1.03 and 95% CI was 1-1.061.The difference was statistically significant(P<0.05).Among them,elevated TSH promoted the highest relative risk of cirrhosis in CHB patients.The FT3 and sex were protective factors of cirrhosis in CHB patients.The OR value of FT3 was 0.389 and 95% CI was 0.182-0.829;the OR value of sex was 0.411 and 95% CI was 0.174-0.974.The difference was statistically significant(P<0.05).Conclusion: 1.The thyroid hormones and antibodies of CHB patients are different from those of controls.Compared with the control group,the levels of FT3,FT4 and TG decease while the level of TSH and positive rates of TPOAb,TGAb and TRAb increase.2.There is a difference in secretion between thyroid hormones and antibodies in CHB patients with different grades.The level of FT3 decreases with the increase of CHB grade,the level of TSH increases with the increase of CHB grade,and the levels of FT3 and TSH reflect the degree of liver function impairment from another side.The reliability of TSH is better than that of FT3.3.The levels of FT3 and TG decrease while the level of TSH increases in CHB patients with liver failure.FT3 and TG are the protective factors for liver failure in CHB patients,but TSH is not an independent risk factor for liver failure in CHB patients,which indicates that the patients with a low level of FT3 might be more prone to develop the liver failure.4.The levels of FT3,FT4 and TG decrease in CHB patients with cirrhosis,and the positive rates of TSH and TRAB increase.TSH is an independent risk factor for cirrhosis in CHB patients while FT3 is a protective factor for cirrhosis in patients with CHB.The results suggest that TSH may promote the hepatic fibrosis while FT3 may have a negative effect on the progression of hepatic fibrosis in CHB patients. |
PDF Full Text Request