甲状腺功能测定对内分泌突眼的诊断价值

Study on diagnostic value of determination of serum thyroid function parameters for Graves' ophthahnopathy

目的探讨三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺素(TSH)测定对内分泌性突眼的诊断价值。方法采用化学发光法检测130例Graves病(GD)伴眼球突出患者、127例单纯性GD患者、128例正常人血清T3、FT3、T4、FT4、TSH水平,并对检测结果进行比较分析。结果与正常对照组相比,GD伴眼球突出患者和单纯GD患者血清T3、FT3、T4、FT4、TSH水平明显升高(P<0.05),GD伴眼球突出患者和GD患者血清T3、FT3、T4、FT4、TSH水平无明显差异,这些指标水平与突眼呈相关关系。结论甲状腺功能的测定虽然对GO的诊断作用无明显帮助,却有助于临床医生判断突眼的严重程度,从而制定合理的治疗方案。

Objective To explore the diagnostic value of determination of serum levels of T3 , FT3 , T4, FT4 and TSH in diagnosis of Graves＇ophthalmopathy. Methods Serum levels of T3 , FT3 , T4, FT4 and TSH were detected in 130 patients with Graves＇disease （GD） and exophthalmos, 127 patients with simple GD, and 128 healthy persons by using chemiluminescence method. The resuhs of above - mentioned parameters were compared and analyzed. Results In comparison with normal control group, serum levels of T3 , FT2 , T4, FT4 and TSH were significantly elevated in patients with GD and exophthalmos and patients with simple GD （ P 〈 0.05 ）. There was no significant difference in serum levels of T3 , FT3 , T4 , FT4 and TSH between patients with GD and exophthalmos and patients with simple GD. These parameters were positively correlated with ophthalmopathy. Conclusion No obvious help was found solely relying on conventional determination of thyroid function for diagnosis of Graves＇disease with exophthalmos. However, it may help clinicians in assessing severity of patients with Graves＇ophthalmopathy and selection of rational therapy.