甲状腺毒症患者甲状腺上动脉收缩期平均峰流速与摄碘率相关分析

Relationship between Mean Peak Systolic Velocity of the Superior Thyroid Artery and Radioactive Iodine Uptake in Patients with Thyrotoxicosis

目的:探讨未经治疗的甲状腺毒症患者甲状腺上动脉平均峰值流速(mean STA-PSV)与摄碘率的相关性,评价STA-PSV在甲状腺毒症病因鉴别中的价值。方法:本研究为前瞻性临床研究,共入选未经治疗的甲状腺毒症患者145例,包括Graves病组(n=96)和甲状腺炎组(n=49),在1周内测定其摄碘率、甲状腺功能与STA-PSV。采用两独立样本t检验比较Graves病组与甲状腺炎组患者摄碘率、甲状腺功能与STA-PSV的差异,用线性回归分析探讨3 h及24 h摄碘率与STA-PSV之间的相关性,用受试者工作曲线(ROC)评价STA-PSV对于Graves病和甲状腺炎的鉴别价值。结果:Graves病组的STA-PSV显著高于甲状腺炎组[(75.51±2.80)cm/s比(33.16±2.33)cm/s,P<0.05];平均STA-PSV与3 h摄碘率(r=0.532,P<0.001)以及24 h摄碘率(r=0.471,P<0.001)均呈显著正相关。平均STA-PSV鉴别Graves病与破坏性甲状腺炎的ROC曲线下面积为0.825,最佳切点为45.3 cm/s,敏感性为80.4%,特异性为81.4%。结论:平均STA-PSV与甲状腺摄碘率具有良好的相关性。结论:超声下甲状腺上动脉峰流速测定是一种可靠便捷的方法,可部分替代摄碘率用于甲状腺毒症的病因鉴别。

Abstract Objective： To explore the relationship between mean peak systolic velocity of the superior thyroid artery （STA- PSV） and radioactive iodine uptake （RAIU） in patients with thyrotoxicosis. Methods： This study was a prospective clinical study in Chinese population. In all, 145 patients with untreated thyrotoxieosis were recruited. All participants underwent ex- amination of thyroid function, radioactive iodine uptake （RAIU） and ultrasonography. Mean STA-PSV was measured by ultra- sonography. RAIU test identified 96 patients with Graves＇ disease （GD） and 49 patients with destructive thyroiditis （DT）. Student＇s t-test was used to compare differences between groups. Results： The mean STA-PSV was significantly higher in GD group than in DT group [（75.51 ± 2.80） cm/s vs. （33.16 ± 2.33） cm/s, P〈0.05]. The mean STA-PSV correlated positively and significantly with 3h RAIU （r= 0. 532 , P〈0. 001）, as well as with 24h RAIU （r= 0. 471, P〈0. 001）. The area under the ROC curve of mean STA-PSV in the differential diagnosis of GD and DT was 0. 825. The optimal cutoff point of mean STA-PSV was 45.3 cm/s, with a sensitivity of 80.4%and aspecificity of 81.4%. Conclusions： Detection of mean STA-PSV by ultrasonography is concordant with RAIU and is an eligible method for the differential diagnosis of thyrotoxicosis.