甲状腺激素配置与急性肝硬化脱补偿的预后有关
Giovana De Nardin1, Bruno da Silveira Colombo1, Marcelo Fernando Ronsoni1
1Divisão de Gastroenterologia Universidade Federal de Santa Catarina FlorianópolisSC Brasil Divisão de Gastroenterologia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
Archives of endocrinology and metabolism
|October 18, 2024
概括
甲状腺激素水平,包括TSH,ft3和ft4,可以预测退化肝硬化住院患者的死亡率. 结合MELD,TSH和ft3 / fT4比率的新模型显示了改善预后准确性的承诺.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 脱补偿性肝硬化带来了复杂的临床挑战.
- 甲状腺功能障碍在肝病中很常见,但其预后作用尚未完全理解.
研究的目的:
- 评估甲状腺激素配置文件的预后意义在患者住院治疗失补偿性肝硬化.
- 为了识别与90天死亡率相关的甲状腺激素标记物.
主要方法:
- 对119名因失补偿性肝硬化住院的患者进行前性队列研究.
- 在入院后24小时内测量TSH,ft3和ft4.
- 90天死亡率的随访和预后因素的分析.
主要成果:
- 患有Child-Pugh C和急性至慢性肝衰竭 (ACLF) 的患者显示甲状腺激素水平发生变化 (较高的fT4,较低的fT3).
- 较低的FT3/FT4比率与炎,感染,ACLF和Child-Pugh C.相关.
- 90天死亡率 (26.9%) 与较高的MELD,较高的TSH和较低的FT3/FT4比率独立相关.
- 结合MELD,TSH和ft3/ft4比率的新型预后模型显示,与单独的MELD (AUC 0.847) 相比,其预测准确度更高 (AUC 0.899).
结论:
- 甲状腺激素样式与非补偿性肝硬化不良结果有显著的相关性.
- TSH,FT3和FT4水平,特别是FT3/FT4比率,可以作为有价值的预后指标.
- 将甲状腺激素测量纳入临床实践可以提高患者风险分层和管理.
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