【摘要】 目的 通過檢測臨床確診為慢性乙型肝炎患者血清谷丙轉氨酶（ALT）、谷草轉氨酶（AST）、甲狀腺激素T3、T4及促甲狀腺素（TSH）含量，進一步探討慢性乙型肝炎患者肝損情況與甲狀腺分泌功能的關系。 方法 收集2009年1-4月79例確診為慢性乙型肝炎患者（病例組）血清標本，分別檢測其ALT、AST、甲狀腺激素T3、T4及TSH含量。以同期健康體檢者30例作為對照組。比較兩組的差異及各指標間的相關性。 結果 病例組AST為（87±113） U/L、ALT為（135±241） U/L、AST/ALT為0.97±0.57、TSH為（1.63±1.29） mU/L、T3為（1.61±0.52）ng/mL、T4為（10.7±2.9） μg/dL，對照組分別為（23±5） U/L、 （18±5） U/L、1.31±0.26、（2.13±0.90） mU/L、（1.19±0.16） ng/mL和（8.6±0.9） μg/dL，兩組各指標比較均有統計學差異（P lt;0.01）。所有指標均正常的共有6例（7.6%），有73例（92.4%）存在不同程度的指標異常；在68例AST/ALT比值降低的慢性乙型肝炎患者（93.2%）中，伴有單純T4升高的有11例（16.2%），單純T3升高的有4例（5.9%），T3、T4同時升高的有11例（16.2%），T3、T4同時升高且TSH降低的有2例（2.9%），1例T4升高且TSH降低（1.5%），1例僅TSH升高（1.5%）；在4例AST/ALT比值正常的慢性乙型肝炎患者（5.5%）中，有1例T3、T4同時升高且TSH降低，1例T3和T4同時升高，1例單純T4升高，1例單純TSH降低；有1例僅AST/ALT比值升高而其他項正常。 結論 慢性乙型肝炎患者除AST/ALT比值異常外，還同時伴有不同程度的甲狀腺激素指標異常，其原因可能與慢性乙型肝炎應用干擾素治療時甲狀腺功能受損有關。
【Abstract】 Objective To explore the relationship between liver damage and the secretion function of thyroid by detecting the serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), T3, T4, and thyroid stimulating hormone (TSH) in patients with chronic hepatitis B. Methods The serum samples of 79 patients with chronic hepatitis B from January to April 2009 were collected, and the ALT, AST, T3, T4, and TSH concentrations were detected. Another 30 healthy subjects were selected as the control. The detected indexes were compared between the two groups. Results In the case group, the concentration of AST was (87±113)U/L, ALT was (135±241)U/L,AST/ALT was 0.97±0.57, TSH was (1.63±1.29) mU/L, T3 was (1.61±0.52) ng/mL, and T4 was (10.7±2.9) μg/dL; while in the control group, the concentrations of the items were (23±5) U/L, (18±5)U/L, 1.31±0.26, (2.13±0.90) mU/L, (1.19±0.16) ng/mL, and (8.6±0.9) μg/d L, respectively. The differences between the two groups were significant (P lt;0.01). Among the 79 case, 6 (7.6%) had a totally normal result, and 73(92.4%) had an abnormal result. There were 68 patients who had a low ratio of AST/ALT, among whom 11 (16.2%) had a simple T4 elevation, 4(5.9%) had a simple T3 elevation,11(16.2%) had an elevation of both T3 and T4, 2 (2.9%) had an elevation of both T3 and T4 and a depression of TSH, 1(1.5%) had an elevation of T4 and a depression of TSH, and 1 (1.5%) had a simple TSH elevation. There were 4 cases who had a normal ratio of AST/ALT, among whom 1 had an elevation of both T3 and T4 and a depression of TSH, 1 had an elevation of both T3 and T4, 1 had a simple T4 elevation, and 1 had a simple TSH depression. There was 1 case who had only an elevation of AST/ALT. Conclusion Most of the patients with chronic hepatitis B have an abnormal result of thyroid hormone together with the abnormal ratio of AST and ALT. The reason mainly lies in the damage of thyroid function by the usage of interferon for the therapy of chronic hepatitis B.
Citation： FENG Pingfeng,PAN Jie,WEI Dong,YANG Chunli,CHEN Yu,WANG Congrong,QIU Yurong. Relationship between AST/ALT Ratio and Thyroid Hormone Level in Patients with Chronic Hepatitis B. West China Medical Journal, 2010, 25(11): 2055-2057. doi: Copy
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