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《慢性HBV感染合并甲状腺功能亢进症16例临床分析-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、·884·中国热带医学2014年第14卷第o7期ChinaTropicalMedicine,July20t4,Vo1.14,No.07慢性HBV感染合并甲状腺功能亢进症16例临床分析·短篇论著·汤颖,刘海蔚海南省人民医院内分泌科,海南海口570311摘要:目的探讨慢性HBV感染合并甲状腺功能亢进症(甲亢)的临床特点及治疗方法。方法对16例慢性HBV感染合并甲亢患者的临床资料进行回顾性分析。结果16例慢性HBV感染合并甲亢患者,年龄22~62岁,平均年龄33.5岁,男性5例,女性11例。所有患者均有不同程度的甲亢和肝炎症状,以疲乏、食欲不振为主要临床表现14例,占87.50%;体重
2、明显下降者8例,占50.0%,体重下降范围为3-12kg/w;恶心、呕吐6例,占37.50%;食欲亢进仅1例,占6.25%。甲状腺肿大12例,占75.o0%,其中I~Ⅱ度肿大7例,占43.75%;ALT升高12例,轻度7例、中度4例、重度1例;胆红素升高l1例,多数为轻度升高,最高者为40.97I~mol/L。心电图正常9例,占56.25%,窦性心动过速4例,占25.00%。单纯治疗肝炎对甲亢无改善,联合甲亢治疗药物肝功、甲功均得到好转。结论HBV感染者,体重明显下降,食欲不振程度与肝功能损害程度不平行时,应警惕甲亢存在可能,特别是甲状腺肿大、心率增快者。除综合治疗肝炎外,应积极
3、治疗甲亢,抗甲亢药物和放射性碘一131治疗均可选用。关键词:甲状腺;功能亢进;HBV感染;肝功能中图分类号:R512.62文献标识码:A文章编号:10o9—9727(2014)7—884—03Clinicalanalysisof16hepatitisBcasescomplicatedwithhyperthyroidismTANGYing,LIUHai-weiDepartmentofEndocrinologyofHainanProvincialPeoples’Hospital,Haikou570311,Haikou,P.R.ChinaAbstract:ObjectiveToinve
4、stigatetheclinicalfeaturesandtreatmentofhepatitisBcasescomplicatedwithhyperthyroidism.MethodsClinicaldataof16hepatitisBcasescomplicatedwithhyperthyroidismwereretrospectivelyanalyzed.ResultsTheaverageageofthe16patientswas33.5years(22-62years)including5maleCasesand11femaleCases,allpatientshadva
5、ryingdegreessymptomsofhepatitisandhyperthyroidism,14caseswerefatigueandlostapetiteinappetence(87.oo%),8casesexhibitedmarkedlyweightloss(50.o0%)withintherangeof3-12kg,W,6caseswerewiththesymptomsofnauseaandvomiting(37.50%)andrisedbilirubinlevelwasnoticedinacase(6.25%),12caseshadgoiter(75.00%)in
6、cluded7caseswithDegreeI~Ⅱenlargement(43.75%),ALTincreaseoccurredto12casesincluding7mildcases,4moderatecasesandIseverecase;increaseofbilirubinlevelWasdetectedin11casesandmostofthemwereslightlyincreasedandthehighestlevelwas40.97I~mol,L;theelectrocardiogramsof9cas~swerenormal(56.25%)andtaehyeard
7、iawasfoundin4cases(25.oo%).ThetreatmentofhepatitisalonecouldnotimprovethesymptomofhyperthyroidismandtreatmentofhepatitisBincombinationwithantithyroid-drug(ATD)couldefectivelyimproveliverfunctionandthyroidfunction.ConclusionsHyperthyroidism,es
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