关键词: 原发性胆汁性胆管炎, 肝硬化, 甲状腺激素, 甲状腺过氧化物酶抗体, 甲状腺球蛋白抗体

Abstract: Objective The paper aimed to investigate the changes of serum thyroid hormone levels and serum positive rate of anti-thyroid antibody in patients with primary biliary cholangitis (PBC). Methods A total of 94 patients with PBC including 50 cases of cirrhosis (Child-Pugh class A in 29 cases, class B in 15 cases, and class C in 6 cases) and 44 cases of cholangitis were enrolled in our hospital between January 2018 and January 2020, and another 60 healthy volunteers in physical examination in our hospital during the same period were included for control in the study. 5 mL of peripheral venous blood under the morning fasting state was taken to determine serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (thyroid stimulating hormone, TSH) by chemiluminescence immunoassay, and thyroid peroxidase antibody (TPOAB) and thyroglobulin antibody (TGAB) were assayed. Results Serum levels of FT3, FT4 and TSH in patients with cholangitis were (2.4±0.5) ng/L, (1.4±0.2) ng/L and (8.9±2.3) ng/L, and serum positive rates of TPOAb and TGAb were 77.3% and 81.8%, serum levels of FT3, FT4 and TSH in patients with liver cirrhosis were (1.9±0.3) ng/L, (1.0±0.1) ng/L and (19.7±4.9) ng/L, and serum positive rates of TPOAb and TGAb were 70.0% and 64.0%, while serum levels of FT3, FT4 and TSH in healthy subjects were (2.8±0.8) ng/L, (1.8±0.3) ng/L and (3.4±1.2) ng/L, and serum positive rates of TPOAb and TgAb were 0.0% and 0.0%, respectively, suggesting serum FT3 and FT4 levels in patients with cirrhosis and cholangitis significantly lower, serum TSH level was significantly higher than those in healthy persons (P < 0.05), while serum FT3 and FT4 levels in patients with cirrhosis were significantly lower, serum TSH level was significantly higher than those in patients with cholangitis (P < 0.05); there was no significant difference in the positive rates of TPOAb and TgAb between patients with liver cirrhosis and with cholangitis (P > 0.05); serum levels of FT3, FT4 and TSH in cirrhotics with Child-Pugh class A were (2.2±0.4) ng/L, (1.2±0.2) ng/L and (12.2±2.8) ng/L, serum positive rates of TPOAb and TgAb were 69.0% and 48.3%, serum FT3, FT4 and TSH in patients with Child-Pugh class B were (1.8±0.3) ng/L, (0.9±0.1) ng/L and (16.5±3.3) ng/L, serum positive rates of TPOAb and TGAB were 66.7% and 60.0%, and serum FT3, FT4 and TSH levels in patients with Child-Pugh class C were (1.3±0.1) ng/L, (0.6±0.1) ng/L and (20.7±4.6) ng/L, and serum positive rates of TPOAb and TGAB were 66.7% and 50.0%, respectively, suggesting serum levels of FT3 and FT4 significantly different among them, while serum positive rates of TPOAb and TgAb in cirrhotics were not (P > 0.05). Conclusion Serum levels of FT3, FT4 and TSH in patients with cirrhosis and cholangitis change greatly, and serum positive rates of TPOAb and TgAb are significantly high, what it implicate needs further investigation.

Key words: Primary biliary cholangitis, Primary biliary cirrhosis, Thyroid hormone, Thyroid peroxidase antibody, Thyroglobulin antibody