[Analysis of clinical characteristics of patients with hyperthyroidism combined with liver injury].

Objective: To analyze, explore and evaluate the clinical characteristics, abnormal thyroid function and follow-up of anti-hyperthyroidism treatment mode in patients with hyperthyroidism (commonly abbreviated as HT) combined with liver injury. Methods: The clinical data of patients with hyperthyroidism combined with liver injury were retrospectively analyzed, and then patients were divided into treated and untreated group according to whether they received anti-hyperthyroidism treatment before the consultation. Patients' thyroid and liver function test indicators at the time of treatment were analyzed to determine the main cause of liver injury. The characteristics of liver injury were analyzed in the treatment group. Patients with severe thyroid toxicity and hyperthyroidism combined with liver injury were followed-up with anti-hyperthyroid therapy, mainly low-dose methimazole (MMI) and radioactive iodine therapy to evaluate its efficacy and safety. The comparison between data groups was performed by t-test, rank sum test and χ( 2) test. Results: Among the 43 cases with hyperthyroidism combined with liver injury, 19 were males and 24 were females, aged 49.0 ± 14.6 years-old; 16 cases (16/43, 37.21%) aged 40 to≤60 years- old, and 15 cases (15/43, 34.88%) aged > 60 years-old. There were 22 untreated cases (untreated group, accounting for 51.16%), and 21 treated cases with anti-hyperthyroidism (treatment group, accounting for 48.84%) at the time of consultation. Thyroid function indicators (FT3, FT4, TSH) and liver function indicators (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyltransferase, total bilirubin) of the two groups were compared, and the difference was not statistically significant (P > 0.05). The order of liver injury from mild to severe in patients with different treatment options were: methimazole (MMI) < propylthiouracil < radioactive iodine 60岁15例（15/43，34.88%）。就诊时未治疗患者22例（未治疗组，占51.16%），已抗甲亢治疗患者21例（治疗组，占48.84%），两组患者的甲状腺功能指标（游离三碘甲状腺素、游离甲状腺素T4、促甲状腺素）和肝功能指标（丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶、γ-谷氨酰转移酶、总胆红素）比较，差异均无统计学意义（P>0.05）。不同治疗方案的患者肝损伤从轻到重的顺序为：MMI<丙基硫氧嘧啶<放射碘<传统中草药。小剂量MMI用于不同程度肝损伤患者抗甲亢治疗均安全有效。 结论： 甲亢合并肝损伤患者发病与年龄相关，主要原因是甲状腺毒性造成。小剂量MMI用于不同程度肝损伤患者抗甲亢治疗安全有效。.