关键词: 格雷夫斯病, 硫辛酸, 氧化应激反应, 肝损伤

Abstract: Background　Liver damage is common in patients with Graves' disease（GD），and a few of them even have liver failure。The mechanism of GD-induced liver injury remains unclear. Existing studies have found that thyroid hormone can induce oxidative stress in rat liver，and α-lipoic acid（ALA）has the effect of anti-oxidative stress. Objective　To investigate the protective effects and mechanism of ALA in GD complicated with liver damage.Methods　A total of 90 patients who first diagnosed as GD combined with liver damage or had recurrence after one year of initial diagnosis with GD combined with liver damage in the Third Affiliated Hospital of Jinzhou Medical University between May 2015 and December 2016 were selected and divided into three groups：conventional group，hormone group and ALA group，each with 30 cases.Conventional group was given compound diisopropylamine dichloroacetate，silybin capsule combined with methimazole treatment.Hormone group was given methylprednisolone treatment on the basis of treatment in conventional group.ALA group was given ALA treatment on the basis of treatment in conventional group.Alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were detected before treatment and on the 14th and 28th day after treatment；free triiodothyronine （FT3），free thyroxine （FT4），thyroid stimulating hormone （TSH），thyroglobulin antibody （TgAb），thyroid peroxidase antibody （TPOAb），superoxide dismutase （SOD），malondialdehyde （MDA） and total antioxidant capacity （T-AOC） were detected before treatment and on the 28th day after treatment.Results　ALT and AST on the 14th and 28th day of treatment in three groups were lower than those before treatment （P<0.01）．The ALT and AST on the 14th and 28th day of treatment in hormone group and ALA group were lower than those in conventional group （P<0.01）．The ALT and AST of hormone group on the 28th day of treatment were lower than those of ALA group （P<0.01）．TSH level on the 28th day of treatment in three groups were higher than those before treatment，and FT3，FT4，TgAb and TPOAb levels were lower than those before treatment （P<0.01）；TSH level in hormone group and ALA group was higher than that in conventional group on the 28th day，TSH level in ALA group was lower than that in hormone group on the 28th day，FT3，TgAb，TPOAb level in hormone group was lower than that in conventional group and ALA group on the 28th day（P<0.01）．SOD and T-AOC levels on the 28th day of the three groups were higher than those before treatment （P<0.01），and MDA level was lower than that before treatment （P<0.01）．The levels of serum SOD and T-AOC on the 28th day of treatment in hormone group and ALA group were higher than those in conventional group，and MDA was lower than that in conventional group；the levels of SOD and T-AOC on the 28th day of treatment in hormone group were higher than those in ALA group，and MDA level was lower than that in ALA group （P<0.01）．Conclusion　ALA have a protective effect on liver damage by reducing oxidative stress in patients with GD.

Key words: Graves disease, Thioctic acid, Oxidative stress, Liver damage