血清5种甲状腺激素测定在甲状腺疾病诊疗中的应用分析

Application of five Thyroid hormones in the treatment and diagnosis of thyroid diseases

目的分析比较5种甲状腺激素水平在甲状腺疾病患者体内的变化情况及临床意义。方法应用化学发光仪检测1462名来我院就诊的患者血清中总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)五种激素水平,按出现结果的方式组合进行统计,并从诊断甲亢和甲低两方面分别统计五种指标的阳性率。结果在诊断甲亢方面,五种指标的阳性率从高到低分别为TSH(41.31%)>FT3(23.05%)>FT4(19.90%)>T3(16.83%)>T4(13.47%);在诊断甲低方面,五种指标的阳性率从高到低分别为TSH(19.08%)>FT4(15.46%)>FT3(8.89%)>T4(8.34%)>T3(7.59%)。结论无论是在诊断及指导治疗甲亢还是甲低,TSH都是一项非常灵敏的指标,诊断甲亢时,FT3要优于FT4,在诊断甲低方面,FT4要优于FT3,同时游离类激素比总激素能更好地反应甲状腺功能的实际水平;而五种指标的联合使用,对甲状腺疾病的诊断及治疗用药都有着非常重要的指导作用。

Application of five Thyroid hormones in the treatment and diagnosis of thyroid diseasesDING Wen,XUE Qing-huan,WU Wen-jin,et al.（Department of Clinical Laboratory,Baoan Traditional Chinese Medical Hospital of Shenzhen,Shenzhen 518133,China） Objective To compare the vibrations and clinical significance of five Thyroid hormones.Methods Acording to Hyperthyroidism and Hypothyroidism,to calculate the positive rates of the 1462 test results of TT3,TT4,FT3,FT4,TSH by Chemiluminescence.Results In the diagnosis of Hyperthyroidism,the positive rates are ranked by TSH（41.31%）〉FT3（23.05%）〉FT4（19.90%）〉T3（16.83%）〉T4（13.47%）;In hypothyroidism,by TSH（19.08%）〉FT4（15.46%）〉FT3（8.89%）〉T4（8.34%）〉T3（7.59%）.Conclusion Either in the diagnosis or treatment,TSH is a sensitive indicator.FT3 is more sensitive than FT4 in the diagnosis of hyperthyroidism,less sensitive in hypothyroidism.Levels of free hormones is more valuble than total ones.The combinations of five results is significant in the treatment and diagnosis of thyroid diseases.