Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Alley, 900470 Constanta, Romania.
"St. Apostol Andrew" Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania.
Medicina (Kaunas). 2024 Sep 9;60(9):1474. doi: 10.3390/medicina60091474.
: Hepatic cirrhosis is a disease with an increasing frequency globally, but its mechanisms of disease development are not yet completely known. The aim of this study was to evaluate the relationship between thyroid hormone levels (T3, fT4, and TSH) and survival in patients with chronic liver disease. : A total of 419 patients diagnosed with liver cirrhosis were included in the study. The MELD score was computed, and TSH, T3, and fT4 were collected from each patient using the ELISA procedure. Signs and symptoms of liver failure and portal hypertension confirmed the clinical diagnosis of liver cirrhosis, and biological tests and imaging methods confirmed the diagnosis. : The MELD score was positively associated with TSH on admission and TSH on discharge and negatively associated with T3 at discharge. TSH levels were higher in non-survivors than in survivors. The values of T3 and fT4 present no significant changes to be considered as prognostic factors. : Although the differences between the median TSH values of the patients who died and those who survived are not very large, the statistical significance of the data obtained demonstrates that there are changes in metabolism of the thyroid hormones during the progression of liver cirrhosis. It is possible that TSH is the one which maintains the normal balance of thyroid activity for patients with liver cirrhosis, so it can be considered as an important marker of evolution of these patients.
: 全球范围内，肝硬化的发病率呈上升趋势，但该病的发病机制尚不完全清楚。本研究旨在评估慢性肝病患者的甲状腺激素水平（T3、fT4 和 TSH）与生存率之间的关系。: 共纳入 419 例肝硬化患者。采用 ELISA 法检测每位患者的 MELD 评分、TSH、T3 和 fT4。肝衰竭和门静脉高压的体征和症状证实了肝硬化的临床诊断，而生物学检测和影像学方法则证实了诊断。: 入院时 MELD 评分与 TSH 呈正相关，与出院时 T3 呈负相关；出院时 TSH 与 MELD 评分呈正相关。与幸存者相比，非幸存者的 TSH 水平更高。T3 和 fT4 的值没有明显变化，不能作为预后因素。: 尽管死亡患者和存活患者的 TSH 中位数之间的差异不是很大，但所获得数据的统计学意义表明，在肝硬化进展过程中，甲状腺激素的代谢发生了变化。TSH 可能是维持肝硬化患者甲状腺活动正常平衡的因素，因此可以认为其是这些患者病情进展的一个重要标志物。
