关键词: 慢性乙型肝炎, 乙型肝炎表面抗原, 游离三碘甲状腺原氨酸, 游离四碘甲状腺原氨酸, 促甲状腺激素

Abstract: Objective To analyze the correlation between the levels of thyroid hormone and hepatitis B surface antigen (HBsAg) and the severity of chronic hepatitis B patients (CHB). Methods A total of 115 CHB patients admitted from July 2021 to July 2023 were selected as the study subjects of the observation group, and 100 healthy subjects who underwent physical examination during the same period were selected as the control group.The levels of thyroid hormone [free three iodine thyroid original glycine (FT3) and free iodine thyroid four original glycine (FT4), thyroid stimulating hormone (TSH)] and HBsAg levels were compared between these two groups of patients. The association between theses parameters with the severity of illness, and pathological stages of liver cirrhosis were analyzed by Pearson correlation analysis. Results Compared with the levels of serum FT3, FT4, TSH and HBsAg [(4.95±0.61) pmol/L, (17.56±2.34) pmol/L, (2.94±0.31) μIU/mL, and (0.04±0.01) IU/mL, respectively] in the control group, the levels of FT3, FT4 and TSH in the observation group, [(3.75±0.42) pmol/L, (15.41±2.13) pmol/L, and (2.67±0.45) μIU/mL, respectively] were significantly decreased, whereas the HBsAg level [(3.11±1.12) IU/mL] was significantly increased (t=16.973, 7.051, 5.048, 27.041, P<0.05). The levels of FT3, FT4 and TSH in mild hepatitis B patients were (4.15±0.51) pmol/L, (16.24±2.08) pmol/L, and (2.23±0.65) μIU/mL, respectively, which were higher than those of (3.73±0.49) pmol/L, (15.23±2.31) pmol/L, and (1.94±0.52) μIU/mL in moderate hepatitis B patients. The levels in moderate patients were higher than those of 3.34±0.37) pmol/L, (14.19±2.04) pmol/L, and (1.66±0.67) μIU/mL in severe hepatitis B patients. The HBsAg levels in these three groups were gradually increased [(2.45±0.63) IU/mL, (2.84±0.75) IU/mL, (3.23±1.01) IU/mL, F=25.761, 7.604, 7.513, 8.039, P<0.05]. The serum FT3, FT4 and TSH levels in patients with hepatic fibrosis S1 were (4.06±0.61) pmol/L, (16.54±2.23) pmol/L, and (2.62±0.54) μIU/mL, respectively, which were higher than those of (3.75±0.53) pmol/L, (15.17±2.21) pmol/L, and (2.17±0.62) μIU/mL in S2 patients, The levels of S2 patients were higher than those of (3.37±0.49) pmol/L, (14.02±2.45) pmol/L, and (1.83±0.42) μIU/mL in S3 patients, and the levels of S3 patients was higher than those of [(2.68±0.47) pmol/L, (12.81±2.07) pmol/L, and (1.36±0.57) μIU/mL in S4 patients. The HBsAg levels were gradually increased in these four groups [(1.85±0.21) IU/mL, (2.09±0.57) IU/mL, (2.64±0.62) IU/mL, (3.08±0.97) IU/mL, and F=35.438, 11.509, 23.256, 17.201, respectively, P<0.05). By Correlation analysis it was found that the level of thyroid hormone was negatively correlated with the severity of hepatitis B and liver fibrosis (r=-0.458, -0.651, -0.715, -0.694, -0.597, -0.712, P<0.05). HBsAg level was positively correlated with the severity of hepatitis B and liver fibrosis (r=0.531, 0.673, P<0.05). Conclusion The level of thyroid hormone in patients with hepatitis B is closely related to the level of HBsAg and the severity of the disease. A combined detection of FT3, FT4, TSH and HBsAg may effectively evaluate the severity of the disease and predict the progression of fibrosis.

Key words: Hepatitis B, Hepatitis B surface antigen, Free triiodothyronine, Free tetraiodothyronine, Thyroid stimulating hormone