摘要
目的探讨甲状腺上动脉血流峰值速度(PSV)、促甲状腺激素(TSH)、三碘甲状腺原氨酸/甲状腺激素(T_(3)/T_(4))、促甲状腺激素受体抗体(TRAb)对Graves病和无痛性甲状腺炎的鉴别诊断意义。方法回顾性选取2017年8月至2019年3月唐山市工人医院收治的30例Graves病患者和28例无痛性甲状腺炎患者作为研究对象。检测并比较两组实验室指标,包括:3 h摄^(131)I率、24 h摄^(131)I率、PSV、T_(3)/T_(4)、TRAb、TSH;以病理诊断为金标准,计算患者PSV检测和血清指标检测的灵敏度和特异度。结果Graves病患者PSV、T_(3)/T_(4)、TRAb明显高于无痛性甲状腺炎患者,而Graves病患者TSH明显低于无痛性甲状腺炎患者,差异均有统计学意义(P<0.05);受试者工作特征(ROC)曲线分析显示,PSV、TSH、T_(3)/T_(4)、TRAb的曲线下面积(AUC)分别为0.906、0.802、0.806和0.789,对Graves病和无痛性甲状腺炎鉴别诊断的敏感度分别为83.6%、80.8%、70.2%和89.9%,特异度分别为86.8%、75.6%、80.4%和66.5%。结论PSV、TSH、T_(3)/T_(4)、TRAb对Graves病和无痛性甲状腺炎的鉴别诊断具有一定价值,且PSV、TSH、T_(3)/T_(4)、TRAb的鉴别诊断价值为:PSV>T_(3)/T_(4)>TSH>TRAb。
Objective To explore the significance of differential diagnosis of peak velocity of superior thyroid artery blood flow(PSV),thyroid stimulating hormone(TSH),triiodothyronine/thyroid hormone(T_(3)/T_(4)),and thyroid stimulating hormone receptor antibody(TRAb)on Graves disease and and painless thyroiditis.Methods Thirty patients with Graves disease and 28 patients with painless thyroiditis admitted to Tangshan Workers’Hospital from August 2017 to March 2019 were retrospectively selected as the research objects.The laboratory indicators of the two groups were tested and compared,including:^(131)I rate at 3 h,^(131)I rate at 24 h,PSV,T_(3)/T_(4),TRAb,TSH;pathological diagnosis was used as the gold standard to calculate the patient’s PSV test and serum index test sensitivity and specificity.Results Patients with Graves disease had significantly higher PSV,T_(3)/T_(4),and TRAb than patients with painless thyroiditis,while patients with Graves disease had significantly lower TSH than patients with painless thyroiditis,and the difference was statistically significant(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of PSV,TSH,T_(3)/T_(4),and TRAb were 0.906,0.802,0.806,and 0.789,respectively,and they were sensitive to the differential diagnosis of Graves disease and painless thyroiditis.The degrees were 83.6%,80.8%,70.2%,and 89.9%,the specific degrees were 86.8%,75.6%,80.4%,and 66.5%.Conclusion PSV,TSH,T_(3)/T_(4),TRAb have certain value in the differential diagnosis of Graves disease and painless thyroiditis,and the differential diagnosis value of PSV,TSH,T_(3)/T_(4),TRAb is:PSV>T_(3)/T_(4)>TSH>TRAb.
作者
王晨
何金花
张博学
李莎
WANG Chen;HE Jin-hua;ZHANG Bo-xue(Department of Endocrinology,Tangshan Workers'Hospital,Tangshan Hebei 063000,China;Department of Special Type Diabetes,Second Hospital of Shijiazhuang,Shijiazhuang Hebei 050051,China;Department of Ultrasound Diagnosis,Tangshan Workers'Hospital,Tangshan Hebei 063000,China)
出处
《临床和实验医学杂志》
2021年第23期2531-2535,共5页
Journal of Clinical and Experimental Medicine
基金
河北省卫生健康委科研基金(编号:20201504)。
作者简介
通讯作者:王晨,E-mail:yuyefeng0@126.com。
