肝移植受者围手术期甲状腺激素水平对预后的影响

目的 探讨肝移植受者围手术期甲状腺激素水平对预后的影响.方法 采用放射免疫法检测82例原位肝移植受者和20例健康对照者血清中总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)以及促甲状腺激素(TSH)的水平;观察受者术后肝功能和存活情况,并分析甲状腺素水平的变化对肝功能和死亡率的影响.结果 肝移植受者术前TT3和TT4水平明显低于健康对照者,且受者的甲状腺激素水平随肝功能水平降低而显著下降.术后2周内有72例受者甲状腺激素水平恢复正常,其中7例死亡,死亡率为9.7%;有10例甲状腺激素水平未恢复正常,其中5例死亡,死亡率为50%,两组死亡率的比较.差异有统计学意义(P<0.05).结论 肝移植术前甲状腺激素水平的降低与肝功能损害程度呈正相关;甲状腺激素水平可作为判断肝移植预后的指标.

The change of thyroid hormone level before and after liver transplantation and its prognostic significance

Objective To observe perioperative change of thyroid hormone level and evaluate its prognostic significance. Methods The concentration of thyroid hormone was detected and compared with liver function and survival in 82 patients receiving liver transplantation. Results Preoperatively, the concentration of TT3 and TT4 in patients receiving liver transplantation was significantly lower than in control group. The concentration of TT3 and TT4 was decreased significantly when liver func-tion got worse. Thyroid hormone level of 72 recipients recovered to normal, and 7 patients died among these patients with the mortality being 9.7%. Thyroid hormone level of 10 patients didn't recover and 5 died with the mortality being 50% (P<0.05). Conclusion The decrease of TT3 and TT4 levels in patients receiving liver transplantation was correlated with worse liver function, and TT3 and TT4 level could be used to predict the prognosis.