Tran Huy Anh, Malcolm Reeves Glenn Edward, Gibson Robert, Attia John Richard
Hunter Area Pathology Service, John Hunter Hospital, University of Newcastle, New South Wales, Australia.
J Gastroenterol Hepatol. 2009 Jul;24(7):1163-8. doi: 10.1111/j.1440-1746.2009.05874.x.
Thyroid dysfunction is the most common endocrinopathy associated with hepatitis C and its interferon-based treatment. When undergoing treatment, interferon and ribavirin synergize to potently stimulate the immune system in order to eradicate the virus. One of the innocent bystanders in this accentuated response is the thyroid. The present study investigated whether thyroid dysfunction while undergoing combination treatment for hepatitis C is a favorable prognostic maker for a sustained virological response.
We carried out a prospective clinical audit in 201 patients treated with combination ribavirin and alpha-interferon and determined the prevalence of sustained virological response in patients in association with thyroid disease. A meta-analysis was also carried out pooling 741 patients from four previous studies on this topic.
There was positive and significant association between thyroid disease and viral clearance. This was not supported by the meta-analysis, however, and some plausible explanations are proffered for this inconsistency.
Despite lacking supportive evidence from the meta-analysis, it is important that this information is confirmed (or refuted) in future studies.
甲状腺功能障碍是与丙型肝炎及其基于干扰素的治疗相关的最常见内分泌疾病。在接受治疗时，干扰素和利巴韦林协同作用以有效刺激免疫系统来根除病毒。在这种增强反应中无辜的旁观者之一就是甲状腺。本研究调查了丙型肝炎联合治疗期间的甲状腺功能障碍是否是持续病毒学应答的良好预后指标。
我们对201例接受利巴韦林和α干扰素联合治疗的患者进行了前瞻性临床审计，并确定了与甲状腺疾病相关的患者中持续病毒学应答的发生率。还对之前四项关于该主题研究的741例患者进行了荟萃分析。
甲状腺疾病与病毒清除之间存在积极且显著的关联。然而，荟萃分析并未支持这一点，并对这种不一致性提出了一些合理的解释。
尽管荟萃分析缺乏支持性证据，但在未来研究中确认（或反驳）这一信息很重要。
