聚乙二醇干扰素α 2a 会导致慢性乙型肝炎患者发生甲状腺疾病吗？
Can pegylated interferon α 2a cause development of thyroid disorders in patients with chronic hepatitis B?
机构信息
Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, Department of Infectious Diseases and Hepatology , ul. Św. Floriana 12, 85 030 Bydgoszcz , Poland +48 52 325 56 05 ; +48 52 345 71 95 ;
出版信息
Expert Opin Drug Saf. 2014 Aug;13(8):1009-14. doi: 10.1517/14740338.2014.921156. Epub 2014 Jun 14.
INTRODUCTION
Hepatitis B virus infection is treated with pegylated (Peg) IFNα and nucleos(t)ide analogues. The disadvantages of PegIFNα include thyroid disorders. In this single-center study, the type, incidence and consequences of thyroid dysfunction in patients receiving PegIFNα due to chronic hepatitis B (CHB) were analyzed.
PATIENTS AND METHODS
The analysis included 106 patients (80 males) with CHB, aged 20 - 58 years, treated with PegIFNα-2a at a dose of 180 μg/week subcutaneously for 48 weeks. The levels of thyroid-stimulating hormone (TSH) and thyroid antibodies (TAbs) that is anti-thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies were measured in all patients at baseline. Furthermore, TSH was measured every 3 months during treatment and for 12 months after completion of treatment. If the TSH level was abnormal, free thyroxine 4 levels and TAbs were measured.
RESULTS
All patients started the therapy with normal TSH and TAb levels. In 99 patients, TSH levels remained normal throughout the therapy. Thyroid disorder occurred in seven patients (6.6%), six of whom developed hypothyroidism and one who developed hyperthyroidism. Thyroid dysfunction was diagnosed in six women and one man. TAbs (only TPOAbs) were found in two patients (1.88%).
CONCLUSIONS
Thyroid disorder is a rare, though possible not transient, complication of IFN therapy in CHB patients.
简介
乙型肝炎病毒感染采用聚乙二醇（Peg）干扰素α和核苷（酸）类似物治疗。聚乙二醇干扰素α的缺点包括甲状腺疾病。在这项单中心研究中，分析了由于慢性乙型肝炎（CHB）而接受聚乙二醇干扰素α治疗的患者的甲状腺功能障碍的类型、发生率和后果。
患者和方法
该分析包括 106 名（80 名男性）年龄在 20-58 岁的 CHB 患者，接受聚乙二醇干扰素α-2a 治疗，剂量为每周 180μg，皮下注射，疗程为 48 周。所有患者在基线时均测量甲状腺刺激激素（TSH）和甲状腺抗体（TAbs），即抗甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体。此外，在治疗期间每 3 个月测量一次 TSH，并在治疗结束后 12 个月测量一次。如果 TSH 水平异常，则测量游离甲状腺素 4 水平和 TAbs。
结果
所有患者开始治疗时 TSH 和 TAb 水平均正常。在 99 名患者中，TSH 水平在整个治疗过程中均保持正常。有 7 名患者（6.6%）发生甲状腺功能障碍，其中 6 名发生甲状腺功能减退，1 名发生甲状腺功能亢进。甲状腺功能障碍诊断为 6 名女性和 1 名男性。两名患者（1.88%）发现 TAbs（仅 TPOAbs）。
结论
甲状腺功能障碍是 CHB 患者 IFN 治疗的罕见但可能不是短暂的并发症。
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