甲状腺功能异常相关肝损伤的研究进展
DOI: 10.12449/JCH260128
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:刘叶负责课题设计,撰写论文;吴晶燕负责资料分析;钟沁洋参与收集数据,修改论文;李武负责拟定写作思路,指导撰写文章并最后定稿。
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摘要: 甲状腺是人体最大的内分泌器官,其功能异常可导致不同程度的肝损伤,严重时甚至引起肝衰竭。甲状腺功能亢进症患者肝功能异常的发生率较高,可表现为肝细胞损伤或胆汁淤积型肝损伤;甲状腺功能减退症则与代谢相关脂肪性肝病密切相关。桥本甲状腺炎、亚急性甲状腺炎等自身免疫性甲状腺疾病常伴发自身免疫性肝病。此外,抗甲状腺药物、胺碘酮及免疫检查点抑制剂等药物也可经直接毒性或免疫介导机制引起严重肝损伤。尽管近年来相关诊治技术取得明显进展,但在发病机制、个体化治疗策略、早期预警和预后评估等方面仍面临诸多挑战。本文系统梳理了甲状腺功能异常相关肝损伤的研究进展,提出未来研究的重点方向,以期为临床诊治提供参考依据。Abstract: The thyroid gland is the largest endocrine organ in the human body, and its dysfunction can cause varying degrees of liver injury, leading to liver failure in severe cases. Patients with hyperthyroidism have a relatively high incidence rate of liver dysfunction, manifesting as hepatocellular injury or cholestatic liver injury, while hypothyroidism is closely associated with metabolic dysfunction-associated fatty liver disease. Autoimmune thyroid diseases, including Hashimoto’s thyroiditis and subacute thyroiditis, are commonly comorbid with autoimmune liver disease. In addition, medications such as antithyroid drugs, amiodarone, and immune checkpoint inhibitors can cause severe liver injury through direct toxicity or immune-mediated mechanisms. Although significant progress has been achieved in related diagnosis and treatment techniques in recent years, there are still many challenges in pathogenesis, individualized treatment strategies, early warning, and prognostic evaluation. This article systematically reviews the research advances in liver injury associated with thyroid dysfunction and proposes the directions for future research, in order to provide guidance for clinical diagnosis and treatment.
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Key words:
- Hyperthyroidism /
- Hypothyroidism /
- Liver Injury /
- Therapeutics
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