Walfish P G, Orrego H, Israel Y, Blake J, Kalant H
Ann Intern Med. 1979 Jul;91(1):13-6. doi: 10.7326/0003-4819-91-1-13.
Admission serum triiodothyronine (T3) values in 124 patients hospitalized for alcoholic liver disease were correlated with clinical and laboratory indices of liver function and commonly used determinants of thyroid function. Patients with low admission serum T3 levels had significant alterations in serum albumin, bilirubin, prothrombin time, and alkaline phosphatase associated with clinical signs of portal hypertension and collateral circulation, with little difference in serum glutamic-oxaloacetic transaminase, serum gamma glutamyl transpeptidase, or serum ornithine carbamyl transferase. This group also had a significant decrease in free T3 index despite an increase in T3 uptake; the slight reduction in total thyroxine (T4) was associated with an increase in free T4 index and no change in serum thyrotropin (TSH). For patients with alcoholic liver disease, low admission serum T3 and free T3 index values when accompanied by normal serum T4, free T4 index, and TSH levels appear to be indicative of severe liver dysfunction and increased mortality risk.
124例因酒精性肝病住院患者的入院血清三碘甲状腺原氨酸(T3)值与肝功能的临床和实验室指标以及常用的甲状腺功能决定因素相关。入院血清T3水平低的患者血清白蛋白、胆红素、凝血酶原时间和碱性磷酸酶有显著改变,伴有门静脉高压和侧支循环的临床体征,而血清谷草转氨酶、血清γ-谷氨酰转肽酶或血清鸟氨酸氨基甲酰转移酶差异不大。尽管T3摄取增加,但该组的游离T3指数也显著降低;总甲状腺素(T4)略有降低与游离T4指数增加及血清促甲状腺激素(TSH)无变化有关。对于酒精性肝病患者,入院血清T3和游离T3指数值低,同时血清T4、游离T4指数和TSH水平正常,似乎表明肝功能严重受损且死亡风险增加。