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目的探讨α干扰素治疗的慢性乙型肝炎儿童诱发甲状腺功能紊乱的临床特点。方法 2010年1月至2011年12月在解放军第302医院青少年肝病科住院,干扰素α为基础抗病毒治疗并随访的慢性乙型肝炎儿童406例,每24周检查甲状腺功能五项,对随访的结果进行统计分析。结果 (1)本组患儿25.86%出现甲状腺功能紊乱,以亚临床甲状腺功能减退为主(17.98%),6.16%出现甲状腺功能减退症,1.72%为甲状腺功能亢进症;幼儿组(1~3岁)患儿未见甲状腺功能亢进症,4~7岁(7.55%)及8~16岁(9.26%)组甲状腺功能减退症的发生率明显高于幼儿组(1.44%)。甲状腺功能减退症患儿中女性(11.11%)的发生率明显高于男性(4.15%)。(2)68%的甲状腺功能减退症患儿、42.86%的甲状腺功能亢进症患儿有临床表现;治疗前过氧化酶抗体(TPOAb)、甲状腺球蛋白抗体(Tg Ab)升高的患儿均进展为甲状腺功能疾病。(3)Logistic结果显示,甲状腺功能亢进症和甲状腺功能减退症的发生与女性及治疗前治疗中出现TPOAb、Tg Ab升高相关。结论α干扰素治疗的慢性乙型肝炎儿童诱发甲状腺功能紊乱以亚临床甲状腺功能减退为主,甲状腺功能亢进症和甲状腺功能减退症的发生与女性及治疗前治疗中出现TPOAb、Tg Ab升高相关。
Objective To investigate the clinical features of thyroid dysfunction induced by interferon-alpha in children with chronic hepatitis B (CHB). Methods From January 2010 to December 2011, 406 children with chronic hepatitis B who were hospitalized in the Department of Juvenile Hepatology, People’s Liberation Army 302 Hospital, and interferon α-based antiviral therapy were followed up. Thyroid function was examined every 24 weeks. The results of statistical analysis. Results (1) Thyroid dysfunction was found in 25.86% of the children with subclinical hypothyroidism (17.98%), hypothyroidism in 6.16% and hyperthyroidism in 1.72% The incidence of hypothyroidism was significantly higher in children aged 4-7 years (7.55%) and in patients aged 8-16 years (9.26%) than in children (1.44%). The incidence of women with hypothyroidism (11.11%) was significantly higher than that of men (4.15%). (2) 68% of children with hypothyroidism and 42.86% of children with hyperthyroidism have clinical manifestations. Children with elevated serum levels of TPOAb and Tg Ab before treatment Progress for thyroid disease. (3) The results of Logistic showed that the incidence of hyperthyroidism and hypothyroidism was related to the increase of TPOAb and Tg Ab in women and before treatment. Conclusions The incidence of thyroid dysfunction induced by interferon alpha in children with chronic hepatitis B is mainly due to subclinical hypothyroidism. The incidence of hyperthyroidism and hypothyroidism is associated with elevated levels of TPOAb and Tg Ab in women and before treatment .