甲状腺功能6项指标联合检测评估甲状腺疾病的价值

Role of combined detecting 6 indexes of thyroid function in evaluation of thyroid diseases

目的探讨甲状腺功能6项指标联合检测评价甲状腺功能及其临床意义。方法甲状腺疾病患者200例均分为四组:甲状腺功能亢进(A)组、Graves病(B)组、甲状腺功能减退(C)组和桥本甲状腺炎(D)组;另设健康对照组(E组,50例)。采用免疫化学发光法检测血清游离三碘甲状腺氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、促甲状腺受体抗体(TRAb)水平,分析组间差异。结果 A组与B组血清FT3、FT4水平明显高于E组,TSH水平低于E组;C组与D组血清FT3、FT4水平明显低于E组,TSH水平高于E组(P<0.05);五组FT3、FT4、TSH诊断符合率差异均无统计学意义(P>0.05)。A组、B组、C组、D组患者血清TGAb、TPOAb、TRAb阳性率与E组比较差异有统计学意义(P<0.05)。结论联合检测FT3、FT4、TSH和TGAb、TPOAb和TRAb在甲状腺疾病的鉴别诊断、治疗及判断预后具有参考价值,可指导临床用药。

Objective To explore the clinical significance of combined detection of 6 indexes for evaluation of thyroid function. Methods A total of 200 patients with thyroide disesases was equally divided into four groups of A （with hyperthyroidism）, B （with Graves＇ disease）, C （with hypothyroidism）,D（with Hashimoto＇s thyroditis）. Fifty healthy people（group E） were taken as the controls. Serum levels of free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ）, thyroid stimulating hormone （ TSH ）, thyroglobulin antibody （ TGAb ）, thyroid peroxidase antibody （ TPOAb ） and thyrotrophin receptor antibody（TRAb） were detected by chemiluminescence immunoassay and the differences among 5 groups were analyzed. Results Serum FT3 and FT4 were higher, but TSH was lower,in groups of A and ]3 than those in group E（P〈0. 05）. Serum FT3 and FT4 were lower, but TSH was higher, in groups of C and D than those in group E（P〈0. 05）. The accordance rates of FT3,FT4 and TSH in the diagnosis of 4 kinds of thyroide disesases were similar（P〉0. 05）. The positive rates of TGAb, TPOAb and TRAb were statistically different between the groups of A, B, C, D and the group E（P〈0. 05）. Conclusion Combined detection of FT3,FT4,TSH,TGAb,TPOAb and TRAb plays an important role in identification, diagnosis and treatment of thyroid diseases.