关键词: 甲亢重度肝损害, 糖皮质激素, 血浆置换, ¹³¹I , 治疗

Abstract: Objective To explore the treatment mode of hyperthyroidism patients with severe liver damage.Methods The clinical data and treatment outcome of 4 patients with severe hyperthyroidism were analyzed retrospectively.Results Among the 4 patients,1 male and 3 female,aged 29-58 years old,with no hyperthyroidism and no antithyroid drugs have been used.Among them,2 cases were subacute liver failure,2 cases were complicated with decompensated cirrhosis of autoimmune liver disease,TBil was higher than 10 × ULN,ALT,AST,ALP and GGT were higher in different degrees.The patients were treated with β-blocker,glucocorticoid and ¹³¹I after plasma exchange.The patients were followed up for 5 months and 3 months respectively.The liver function of patients with subacute liver failure recovered completely.The patients with cirrhosis were stable.Conclusion β-blocker,glucocorticoid and artificial liver should be used as adjuvants in the treatment of hyperthyroidism patients with severe liver damage,and 131I treatment opportunity should be created in time,which can effectively improve the liver function and prognosis.

Key words: hyperthyroid severe liver damage, glucocorticoid, plasma exchange, ¹³¹I, treatment