关键词: 肝炎, 丙型, 慢性, 抗病毒治疗, 甲状腺功能, 干扰素-&alpha, 2b, 利巴韦林

Abstract:

Objective To investigate the dynamic changes and prognosis of thyroid function in the patients with chronic hepatitis C (CHC) after antiviral treatment,and to clarify the  influence of  baseline factors in the changes of thyroid function.Methods 243 CHC patients with normal baseline thyroid function
 were enrolled.All patients were treated with  IFN-alpha-2b(IFN-α2b) combined with ribavirin for 48 weeks.The thyroid function and serum HCV RNA level were assessed at 12,24,36,48,60 and 72 weeks. According to the changes in thyroid function after treatment,the patients were divided into continued normal,subclinical hypothyroidism,hypothyroidism and hyperthyroidism groups.The regularity of the changes of thyroid function of the patients in various groups were observed.
Results Among 243 CHC patients,82(33.7%) patients had thyroid dysfunction. The  prevalence of subclinical hypothyroidism,hypothyroidism and hyperthyroidism were 20.9%(51/243),5.3%(13/243)  and 7.4%(18/243),  respectively. At the end of 72 weeks,there were 32(39.0%) patients suffering from subclinical hypothyroidism，12(14.6%)  patients with  hypothyroidism  and 7(8.5%)  patients with hyperthyroidism  rehabilitated.6（7.3%）　patients suffering from hypothyroidism turned to subclinical hypothyroidism,and 3(3.7%） patients suffering from hyperthyroidism turned to subclinical hypothyroidism.19（23.2%） patients had no significant change,they performed for continued subclinical hypothyroidism (1,1.2%),hypothyroidism (13,15.9%） and hyperthyroidism (5,6.1%).In addition,3 (3.7%) patients with hyperthyroidism turned to hypothyroidism.  An increased risk for hypothyroidism was found in female patients compared with males (P<0.05);the average age of the patients with hyperthyroidism was lower than those of the patients with hypothyroidism,subclinical hypothyroidism and continued normal (P<0.05);the baseline levels of GGT in the patients with hyperthyroidism and hypothyroidism were lower than those of the patients with subclinical hypothyroidism and continued normal(P<0.05).The ratio of the patients with HCV 2a to the patients with hypertyroidism was higher than those of the patients with hypothyroidism,subclinical hypothyroidism and continued normal(P<0.05).Conclusion Thyroid function in the CHC patients can be affected by antiviral treatment.Gender,age,liver function,genotype of HCV  are influencing  factors for the changes of thyroid function.
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Key words: hepatitis C,chronic, antiviral treatment, thyroid function, interferon &alpha, -2b, ribavirin