促甲状腺激素对甲状腺功能减退症的临床诊断评价

Clinical diagnosis evaluation of hypothyroidism by thyrotropin

目的评价促甲状腺激素(thyrotropin,TSH)对甲状腺功能减退症(甲减)的诊断性能。方法采用免疫化学发光法测定131例甲减患者及120例正常人的FT3、FT4、TSH,计算FT4/TSH比值,绘制ROC曲线并计算曲线下面积。结果甲减诊断中分离效率分别为FT393.4%,FT498.5%,TSH 79.4%,FT4/TSH 83.2%。甲减诊断ROC面积:TSH为0.87,FT4/TSH为0.92。结论TSH是诊断甲减的灵敏指标,而FT4/TSH更优于单一的TSH。患者资料完善及正常参考范围可能存在的差异会直接影响诊断效率。

Objective To evaluate the credibility of thyrotopin（TSH） for the diagnosis of hypothyroidism. Methods The levels of FT3 ,FT4 and TSH in 131 patients with hypothyroidism and 120 normal persons were measured by immunochemiluminescent method. The ratios of FT4/TSH were calculated. Receiver operating characteristic curve（ROC） was drawn,and the area under the curve was calculated. Results The diagnostic efficiency for hypothyroidism of FT3, FT4, TSH and FT4/TSH was 0. 934,0. 985, 0. 794 and 0. 832,respectively. Conclusion TSH is a sensitive indicator for the hypothyroidism diagnoses, while the FT4/TSH is better than TSH alone. The diagnostic efficiency might be influenced by the difference between the data and different reference range.