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比较¹³¹I和/或人工肝支持系统对肝功能衰竭合并甲状腺功能亢进症的预后影响。

Comparing the prognostic impact of 131I and/or artificial liver support system on liver function failure combined with hyperthyroidism.

作者信息

Fang Danzhou, Li Shiying, Zhou Changgu, Wang Yirui, Yuan Gengbiao, Zhang HuiHui, Rao Maohua

机构信息

Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Endocr Connect. 2024 Oct 7;13(11). doi: 10.1530/EC-24-0330. Print 2024 Oct 1.

Abstract

OBJECTIVE

Hyperthyroidism, a prevalent endocrine disorder, can lead to complications such as liver failure due to the liver's essential role in thyroid hormone metabolism. The study aimed to elucidate the respective contributions of 131I and/or ALSS in managing hyperthyroidism alongside liver failure.

METHODS

A retrospective analysis was carried out on 74 patients diagnosed with severe liver failure in the context of Graves' disease. Patients were categorized into three groups: group A (n = 34) received 131I treatment, group B (n = 17) underwent 131I and ALSS treatment, and group C (n = 24) received artificial liver support system (ALSS) treatment alone.

RESULTS

Throughout the treatment period, the liver function indexes in all groups exhibited a declining trend. The thyroid function of group A and group B treated with 131I was significantly improved compared to that before treatment. There was no significant change in thyroid function in group C. After the correction of hyperthyroidism, significant improvements were observed in the liver function of individuals in groups A and B, particularly with more noticeable amelioration compared to group C. After two months of treatment, the efficacy rates for the three groups were 79.41%, 82.35%, and 60.87% respectively. Mortality rates of the three groups were 5.88%, 17.65%, and 36% (P < 0.01). Group B, receiving both 131I and ALSS treatments, exhibited a lower mortality rate than group C.

CONCLUSION

In cases of severe liver failure accompanied by hyperthyroidism, prompt administration of 131I is recommended to alleviate the adverse effects of hyperthyroidism on liver function and facilitate a conducive environment for the recovery of liver functionality.

摘要

目的

甲状腺功能亢进症是一种常见的内分泌疾病,由于肝脏在甲状腺激素代谢中起着重要作用,可导致肝功能衰竭等并发症。本研究旨在阐明¹³¹I和/或人工肝支持系统(ALSS)在治疗甲状腺功能亢进症合并肝功能衰竭中的各自作用。

方法

对74例诊断为Graves病合并严重肝功能衰竭的患者进行回顾性分析。患者分为三组:A组(n = 34)接受¹³¹I治疗,B组(n = 17)接受¹³¹I和ALSS治疗,C组(n = 24)仅接受人工肝支持系统(ALSS)治疗。

结果

在整个治疗期间,所有组的肝功能指标均呈下降趋势。接受¹³¹I治疗的A组和B组的甲状腺功能较治疗前有显著改善。C组甲状腺功能无显著变化。甲状腺功能亢进症纠正后,A组和B组患者的肝功能有显著改善,尤其是与C组相比改善更为明显。治疗两个月后,三组的有效率分别为79.41%、82.35%和60.87%。三组的死亡率分别为5.88%、17.65%和36%(P < 0.01)。接受¹³¹I和ALSS联合治疗的B组死亡率低于C组。

结论

对于严重肝功能衰竭合并甲状腺功能亢进症的病例,建议及时给予¹³¹I治疗,以减轻甲状腺功能亢进症对肝功能的不良影响,为肝功能恢复创造有利环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/243e/11466263/2e93d4bc6f49/EC-24-0330fig1.jpg

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