Martín-Vivaldi R, Nogueras F, Quintero D, Espinosa M D, López de Hierro M, Suárez J F, González A
Servicio de Digestivo, Hospital Virgen de las Nieves Granada.
Rev Esp Enferm Dig. 1996 Jul;88(7):480-4.
The aim of this study was to evaluate the thyroid function and the dysfunction after interferon therapy in patients with chronic hepatitis C.
Between 1988 and 1994, 119 patients with chronic hepatitis C treated with interferon were reviewed 92 patients received interferon alfa for six or twelve months. 27 patients were treated with interferon beta for six months. Before, during and after interferon therapy, free thyroxine, thyroid-stimulating hormone, antimicrosomal antibodies and antithyroglobulin antibodies were measured in 51 patients. None of the patients had abnormal thyroid function or autoimmune disease before treatment.
Among the interferon-treated patients, 6% developed biochemical evidence of thyroid dysfunction during or after therapy. Most cases had hypothyroidism. Thyroid dysfunction was statistically more frequent in the female sex, older patients and in patients who received greater total dose of interferon. In one patient the titters of antimicrosomal thyroid antibodies increased from 1/10 to 1/40 and another patient was positive in a dilution of 1/80 by the time of onset of thyroid disease. Thyroid disease (hypothyroidism) developed in (3.5%) of untreated patients with chronic hepatitis C.
Interferon therapy can development autoimmune thyroid fenomena. Thyroid dysfunction and the presence of antithyroid antibodies before therapy can be a contraindication to the use of interferon in these patients. It is important that patients undergoing interferon therapy be tested for antithyroid antibodies and thyroid function before treatment and be monitored during the course of therapy. Also, it is important to evaluate the factors related with the development of thyroid dysfunction (age, sex, interferon dose...).
本研究旨在评估慢性丙型肝炎患者接受干扰素治疗后的甲状腺功能及功能障碍情况。
1988年至1994年间，对119例接受干扰素治疗的慢性丙型肝炎患者进行了回顾性研究。92例患者接受了α干扰素治疗6或12个月。27例患者接受了β干扰素治疗6个月。在51例患者中，于干扰素治疗前、治疗期间及治疗后检测了游离甲状腺素、促甲状腺激素、抗微粒体抗体和抗甲状腺球蛋白抗体。治疗前所有患者的甲状腺功能及自身免疫性疾病均无异常。
在接受干扰素治疗的患者中，6%在治疗期间或治疗后出现了甲状腺功能障碍的生化证据。大多数病例为甲状腺功能减退。甲状腺功能障碍在女性、老年患者以及接受干扰素总剂量较大的患者中在统计学上更为常见。1例患者抗微粒体甲状腺抗体滴度从1/10升至1/40，另1例患者在甲状腺疾病发作时抗体稀释度为1/80时呈阳性。未接受治疗的慢性丙型肝炎患者中有3.5%发生了甲状腺疾病（甲状腺功能减退）。
干扰素治疗可引发自身免疫性甲状腺现象。治疗前甲状腺功能障碍及抗甲状腺抗体的存在可能是这些患者使用干扰素的禁忌证。接受干扰素治疗的患者在治疗前检测抗甲状腺抗体和甲状腺功能并在治疗过程中进行监测非常重要。此外，评估与甲状腺功能障碍发生相关的因素（年龄、性别、干扰素剂量……）也很重要。
