Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism
Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism
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泼尼松和左甲状腺素联合治疗可改善乙型肝炎严重血小板减少症伴代偿性肝硬化伴亚临床和明显甲状腺功能减退症的治疗
DOI：
10.1007/s11427-017-9250-1
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Xiaohui Zhang
中科院分区：
文献类型：
--
作者：
Jing Xue;Ru Feng;Haixia Fu;Qian Jiang;Hao Jiang;Jing Lu;Hui Liu;Jingwen Wang;Ting Niu;Xin Wang;Y;i Xie;Hao Wang;Lanping Xu;Kaiyan Liu;Xiaojun Huang;Xiaohui Zhang
本研究的目的是在中国开展一项多中心、开放标签、观察性研究，探讨乙型肝炎相关代偿性肝硬化患者甲状腺功能减退和血小板减少之间的关系，并确定左旋甲状腺素和强的松治疗是否更优越。总共纳入125例连续乙型肝炎相关代偿性肝硬化伴严重血小板减少伴甲状腺功能减退患者。根据治疗策略将患者分为4组：对照组（n=29）、强的松组（n=25）、左旋甲状腺素组（n=32）、强的松加左旋甲状腺素组（n=39）。严重血小板减少症在乙型肝炎相关代偿性肝硬化伴甲状腺功能减退患者中比在甲状腺功能正常患者中更为普遍（29.6%比14.7%，P<0.05）。与对照治疗和单独使用强的松或左旋甲状腺素治疗相比，强的松和左旋甲状腺素联合治疗降低了出血风险，改善了血小板恢复。治疗前血小板计数、血清促甲状腺激素及强的松、左甲状腺素联合治疗与出血事件相关。因此，本研究提示，乙型肝炎相关代偿性肝硬化患者甲状腺功能减退与严重的血小板减少有关。强的松加左旋甲状腺素治疗这些患者可能是一种新的治疗方法。
The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis B-related compensatory liver cirrhosis and to determine whether treatment with levothyroxine and prednisone is superior in a multicenter, open-label, observational study in China. In total, 125 consecutive hepatitis B-related compensated liver cirrhosis patients with severe thrombocytopenia accompanied by hypothyroidism were included. The patients were divided into four groups according to treatment strategy: a control group (n=29), a prednisone group (n=25), a levothyroxine group (n=32) and a prednisone plus levothyroxine group (n=39). Severe thrombocytopenia was more prevalent in hepatitis B-associated compensatory liver cirrhosis patients with hypothyroidism than in euthyroid patients (29.6% vs. 14.7%,P<0.05). Combination treatment with prednisone and levothyroxine decreased the risk of bleeding and improved platelet recovery compared to control treatment and treatment with either prednisone or levothyroxine alone. The platelet count before therapy, serum thyroid stimulating hormone and combination treatment with prednisone and levothyroxine were associated with bleeding events. Therefore, the present study suggests that hypothyroidism is associated with severe thrombocytopenia in hepatitis B-associated compensatory liver cirrhosis. Treatment with prednisone plus levothyroxine may present a novel approach in these patients.
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DOI：
10.1515/jpem-2012-0298
发表时间：
2013-02
期刊：
--
影响因子：
--
作者：
S. Sarkar;R. Mondal;M. Nandi;J. Ghosh
通讯作者：
S. Sarkar;R. Mondal;M. Nandi;J. Ghosh
影响因子：
2.4
作者：
Kang MY;Hahm JR;Jung TS;Lee GW;Kim DR;Park MH
通讯作者：
Park MH
影响因子：
6.6
作者：
Garber, Jeffrey R.;Cobin, Rhoda H.;Woeber, Kenneth A.
通讯作者：
Woeber, Kenneth A.
影响因子：
3.7
作者：
Kim SU;Lee JH;Kim DY;Ahn SH;Jung KS;Choi EH;Park YN;Han KH;Chon CY;Park JY
通讯作者：
Park JY
DOI：
10.1016/j.beem.2009.08.003
发表时间：
2009-12
期刊：
Best practice & research. Clinical endocrinology & metabolism
影响因子：
--
作者：
Haugen BR
通讯作者：
Haugen BR